Covering the remaining uninsured children: almost half of uninsured children live in immigrant families.

OBJECTIVE Previous authors have answered "how many children in immigrant families are uninsured"; we do not know the inverse: "how many uninsured children live in immigrant families." This paper will show the total contribution of having an immigrant parent to the uninsured rate for children in the United States. DATA SOURCE Secondary data from the 2008-2010 American Community Survey. STUDY DESIGN Descriptive analyses and a multinomial probit model illustrate the relationship between immigration history and insurance status. PRINCIPAL FINDINGS In 2010, almost half (42%) of uninsured children lived in an immigrant family. State-level estimates range from a low of 4% in Maine to a high of 69% in California. Two thirds (69%) of these uninsured children are citizens; furthermore, 39% are Medicaid eligible, 39% are not eligible for Medicaid, and eligibility is unknown for the 21% that are low-income, noncitizens. CONCLUSIONS In 2000, a third of all uninsured children lived in immigrant families. In 2010, 42% of all uninsured children lived in immigrant families. Initiatives to expand coverage or increase Medicaid and CHIP uptake will require decision makers to develop new policy and outreach approaches to enroll these children so they do not fall further behind.