Latino Immigrants and Health Care Access

Background: Latino children whose parents are unauthorized immigrants have the lowest health insurance coverage among all children in the United States. Among these, children whose parents are immigrant farmworkers may represent an especially vulnerable subset of youth; more than half of farmworker children have undocumented, Mexican parents. Specifically, children of farmworkers are uninsured at 3 times the rate of all children, and almost twice the rate of those at or near the federally defined poverty level. Finally, farmworker children are 2 to 3 times more likely to have poor or fair health compared with good or excellent health of non-farmworker children. The 2009 Children’s Health Program Reauthorization Act (CHIPRA) may have improved children of immigrants’ access to healthcare because it allowed states to extend federal health insurance coverage to immigrant children regardless of their parents’ legal status. Objective: The overall goal of this study is to assess how access to health insurance changed following the enactment of CHIPRA for children of Latino immigrant farmworkers. The effects of CHIPRA are compared over time (comparing pre- and post-CHIPRA) and across state policy environments, chiefly by whether states elected to expand CHIPRA options to children despite their parents’ authorization status, and by whether states eliminated five-year residential requirements as a waiting period. Results: Preliminary results suggest that although all children have increased health insurance access after CHIPRA, children whose parents are unauthorized have less access to insurance compared to children whose parents are citizens. Conclusions: Although there is evidence that CHIPRA increased health insurance among Latino children, the role of parental authorization is a barrier for some children to access services to which they are legally eligible. This study addressed a significant and important question about the role of policy in the reduction of uninsured children, as well as how policy implementation can either reduce or broaden disparities in child health care access.