Mariellen Jewers is an adjunct professor at Rollins College, in Winter Park, Florida. Much of this work was completed while she was a doctoral candidate at the Trachtenberg School of Public Policy and Public Administration at George Washington University, in Washington, D.C.
Leighton Ku (
Health Aff (Millwood). 2021 Jul;40(7):1084-1089. doi: 10.1377/hlthaff.2021.00065.
Immigrant children in the US have very limited health insurance coverage and health care access. Immigration status is not static: Census data show that the majority of census respondents who enter as noncitizen children eventually become citizens. Eligibility restrictions that prevent noncitizen children from being publicly insured can contribute to their experiencing poorer health and higher medical costs in their adult lives. We isolate the impact of lack of citizenship from socioeconomic factors by comparing citizen and noncitizen siblings living in mixed-status families, using fixed-effects models to net out socioeconomic factors shared within families. Lacking citizenship increased a child's risk of being uninsured and lowered by 26 percentage points the chances that they would have Medicaid or Children's Health Insurance Program coverage. Noncitizen children had significantly more delays in needed medical care because of cost, primarily mediated by the lack of insurance coverage. The US should reexamine policies that exclude noncitizen children from public health insurance programs.
美国的移民儿童的医疗保险覆盖范围和医疗保健可及性非常有限。移民身份并非一成不变：人口普查数据显示，大多数以非公民儿童身份入境的人口普查受访者最终成为公民。将非公民儿童排除在公共保险之外的资格限制可能导致他们在成年后健康状况较差，医疗费用更高。我们通过比较居住在混合身份家庭中的公民和非公民兄弟姐妹，使用固定效应模型消除家庭内部共享的社会经济因素，将缺乏公民身份的影响与社会经济因素隔离开来。没有公民身份会增加儿童没有保险的风险，并使他们获得医疗补助或儿童健康保险计划覆盖的机会降低 26 个百分点。非公民儿童因为费用而导致需要的医疗护理延迟的情况明显更多，这主要是由于缺乏保险覆盖。美国应该重新审查将非公民儿童排除在公共医疗保险计划之外的政策。
