EXAMINING THE IMPACTS OF PUBLIC POLICY CHANGES ON IMMIGRANT CHILDREN’S INSURANCE COVERAGE, ACCESS TO CARE, AND HEALTH OUTCOMES

Abstract

A large body of evidence shows that public policies that expanding public insurance eligibility to children would lead to improvements in health care access and health outcomes during childhood. Growing up in the US, immigrant children face multifaceted barriers related to “not from here”, including economic constrains, acculturation pressure, immigration status of self and family members. It is unclear if immigrant children may respond to a public policy that expand public insurance eligibility to them. Prior research showed that immigrants would adjust their participation in public programs and health care utilization based on their perceived immigration climate. However, less is known about the impact of a national immigration enforcement program on immigrant children’s health care access and health outcomes. In this study, I examined two public policies: Children’s Health Insurance Program Reauthorization Act of 2009, the public policy that expanded public insurance eligibility to immigrant children under the five-year bar; and Secure Communities, a national immigration enforcement program that linked federal immigration enforcement activities to local authorities. I found that immigrant children in states that adopted CHIPRA’s option experienced a 6.35 percentage points decrease in uninsurance, and 8.1 percentage points increase in public insurance coverage, while estimated changes on private coverage were not statistically significant. I did not observe any statistically significant effects of CHIPRA on immigrant children’s access to care and health outcomes. My estimates suggested that activation of SC significantly decreased immigrant children’s public insurance coverage by 8.2 percentage points, while the estimates on other outcomes were not statistically significant.