Reasons for and Barriers to Obtaining Insurance among U.S. Children: The Role of Generation Status

Rhonda BeLue, Pennsylvania State University
Patricia Y. Miranda, Pennsylvania State University
Bilikisu Elewonibi, Pennsylvania State University
Marianne M. Hillemeier, Pennsylvania State University

The Patient Protection and Affordable Care Act (ACA) has the potential to reduce the number of uninsured children in the U.S. by as much as 40 percent. Children who are undocumented will remain categorically ineligible for public insurance under the ACA, and many lawfully present immigrant children will continue to experience eligibility restrictions. Analyzing current data from a nationally representative sample of children, we examine differences by immigrant generational status in awareness of options for children’s health insurance coverage. Both first and second generation immigrant children have less potential to gain insurance compared to children in third generation families. While non-citizen immigrants are not covered by ACA insurance expansions, only 37.8% of first generation families report being uninsured due the inability to meet citizenship requirements. ACA navigators and health services professionals should be aware of potential challenges to helping families negotiate Medicaid expansions and State and Federal exchanges.