Immigrant Children’s Access to Public Health Insurance after CHIPRA-2009

Although Immigrant children represent approximately 3 percent of total U.S. child population, they remain the most vulnerable group in terms of access to public health insurance since the enactment of the “five-year-ban” for legal immigrants in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. Children Health Insurance Reauthorization Act (CHIPRA) of 2009 provided states an option to receive federal funds to expand eligibility for immigrant children regardless of their length of residency. In this paper, we utilize the cross-state variation in policy environment before and after the adoption of CHIPRA to compare the differences in access to public health insurance among the low-income immigrant children. We find that adoption immigrant child option of CHIPRA has resulted 8 percentage points increase in health coverage for the target group, almost entirely contributed by equal increase in coverage through public health insurance. Our measure of estimated treatment effect is lower than what existing literature reports. We attribute the difference to the existing state-funded programs to support immigrant children among majority of the CHIPRA states. Increase in coverage entirely comes from the ranks of previously uninsured children; no evidence of crowding out from the private insurance was found. We also verify the lack of crowding out by estimating the labor market response among mothers of immigrant children.