Improving Affordability and Advancing Health Equity for Immigrants

Around 14 percent of the United States population (slightly fewer than 48 million people) are immigrants, and around 13.7 million of these immigrants (fewer than one in four) are estimated to be undocumented.¹ Immigrants face barriers to optimal health, and these barriers have multiple causes. For example, many U.S. health programs place restrictions on enrollment by people who, but for their immigration status, would be eligible: undocumented immigrants (those who lack any legal authorization to be in the United States) are ineligible for any federally funded health coverage programs, and lawfully present immigrants (defined as all immigrants except undocumented immigrants) face additional eligibility restrictions that citizens do not.²

In addition to barriers to eligibility, many health care providers do not have the training or resources available to best support immigrants’ health needs. Similarly, many immigrants are not informed of differences between the U.S. health system and the system of their countries of origin, undermining their ability to receive needed care, and immigrants may reasonably fear that pursuing health care treatment may lead to immigration enforcement against them.

In response to the stark political divide at the federal level on the issue in recent years, states across the country have taken different approaches to supporting the health of residents who are immigrants. Some have enacted anti-immigrant laws specific to health care.³ For example, Florida passed in 2023 an anti-immigration bill that, among other provisions, includes requiring hospitals to collect patient immigration status.⁴ Others have expressed continued support for immigrant health services, regardless of whether they are undocumented or lawfully present.⁵ Immigrants’ access to health services is affected by broad-based as well as health policy-specific policies: fear of deportation, for example, can result in delayed or skipped health care as well as chronic, toxic stress.⁶

This report describes the legal and social barriers that immigrants face to accessing and affording health care. After this, it highlights how states can work to address these barriers, advance health equity, and improve health care affordability for immigrants. It does so against a rapidly changing policy landscape, in which President Trump has prioritized actions to limit new immigration and remove immigrants from this country.⁷

Immigrants Face Legal and Social Barriers to Accessing and Affording Health Care

Compared to U.S. citizens, noncitizen immigrants face significant barriers to eligibility for and enrolling in affordable health coverage, as well as in accessing needed health care. Many of these barriers are the result of state and federal government policies, but others stem from social and cultural differences between immigrant and non-immigrant populations, as well as fear of deportation. This report highlights three of these barriers: a lack of equitable access to health coverage, high health care prices even for those with health coverage, and difficulty navigating the U.S. health system.

It is important to note that immigrant communities are not a monolith. While every immigrant shares the reality of being born outside of the United States and of facing barriers due to antiquated immigration laws, other aspects of their identity, such as race and ethnicity or country of origin, can also drive significant differences in outcomes and health needs. For example, a study of naturalized U.S. citizens found that Mexican immigrants were more likely than other immigrants to have poor physical health, while Central American immigrants tend to have greater rates of psychological distress.⁸ Similarly, research by the Centers for Disease Control and Prevention found that around 35 percent of new tuberculosis cases in 2022 were among immigrants from Mexico, the Philippines, India, and Vietnam, while immigrants from Sub-Saharan Africa and much of Asia are at greater risk of hepatitis B.⁹ This report aims to identify challenges and opportunities that would improve health care affordability and equity for all immigrants.

Many immigrants do not have health coverage.

While coverage rates in the United States have improved since the passage of the Affordable Care Act (ACA), noncitizen immigrants (especially undocumented immigrants) remain significantly more likely to be uninsured than citizens. According to a 2023 survey by KFF, half of undocumented immigrants and nearly 20 percent of lawfully present immigrants reported being uninsured.¹⁰ For comparison, only around 8 percent of U.S.-born citizens and 6 percent of naturalized citizens said they were uninsured.¹¹ This disparity is illustrated in Figure 1.

Figure 1

There are a variety of reasons for these disparities. For example, about half of the U.S. population is insured through employer-sponsored insurance.¹² Immigrants of any status can enroll in private insurance, and even have their monthly premium contribution excluded from their taxable income. However, many lawfully present immigrants work in lower-paying industries, such as construction, agriculture, and hospitality, that are less likely to provide insurance as a benefit.¹³ And without employer contributions, immigrants may struggle to afford private coverage: median income among all immigrants is slightly lower than U.S.-born residents, and immigrants from Latin America, the Middle East, and Sub-Saharan Africa have much lower median incomes.¹⁴

Another source of disparities in coverage rates stems from federal restrictions on eligibility, for both lawfully present and undocumented immigrants. Lawfully present immigrants can be eligible for Medicaid, CHIP, and marketplace coverage, including subsidies for marketplace coverage, depending on their incomes.¹⁵ The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 requires lawfully present immigrants to have resided in the United States for at least five years and have a qualified immigration status before they are eligible for Medicaid or CHIP enrollment.¹⁶ Since 2009, federal law has allowed states to opt to waive this waiting period for children and pregnant women; many states have done so,¹⁷ as shown in Map 1.

Some immigrants, such as asylum seekers and refugees, are exempt from this waiting period, and no waiting period applies for marketplace coverage or subsidies.¹⁸ The Biden administration issued a final rule in May 2024 allowing DACA recipients (a subset of immigrants who arrived in the United States as children) to enroll in marketplace coverage; this rule has been stayed in nineteen states and may be revoked under the Trump administration.¹⁹

Map 1

Undocumented immigrants, on the other hand, are excluded from federally funded health coverage programs like Medicaid, CHIP, and marketplace coverage, regardless of income.²⁰ Some health services provided to undocumented immigrants are covered by emergency Medicaid, which reimburses hospitals for the emergency care they are obligated to provide to individuals who meet other Medicaid eligibility requirements (such as income) but who do not have an eligible immigration status, including undocumented and lawfully present immigrants. Less than 1 percent of all Medicaid spending falls into this category.

Another program which pays for some services undocumented and lawfully present immigrants receive is CHIP. States have the option under CHIP to adopt the “From-Conception-to-End-of-Pregnancy” option to provide perinatal care, regardless of their parent’s citizenship or immigration status.²¹ Twenty-three states and the District of Columbia have adopted this option, previously known as the “unborn child” option, a medically inaccurate term.²²

The federal government also funds programs which may provide primary care and prescription drugs to low-income residents, regardless of immigration status, including federally qualified health centers, migrant health centers, and safety-net hospitals.²³ However, these programs provide access to services, not health coverage, and access to specialty care at these sites is limited.²⁴

States have options to cover immigrants without federal support. A handful of states and the District of Columbia, as shown in Map 2, operate entirely state-funded “Medicaid-like” programs for low-income residents regardless of immigration status; most programs prioritize coverage for children and pregnant people.²⁵ Washington, Colorado, and Maryland have also received federal waivers allowing undocumented immigrants in these states to enroll in marketplace coverage without federal premium tax credits.²⁶

Map 2

Together, these immigration status restrictions result in millions of people being ineligible for health programs. A 2021 analysis of Census Bureau data from before the COVID-19 pandemic found that around 45 percent of the 9.5 million non-elderly foreign-born adults whose incomes would otherwise qualify them for Medicaid were ineligible due to immigration status restrictions.²⁷

The high cost of care undermines access.

Even for immigrants who do have a source of health coverage, the high price of health care can still undermine access. While most immigrants are employed, they are disproportionately likely to work in industries, such as construction, agriculture, and hospitality, that pay lower wages, making care difficult to afford even with health coverage.²⁸

This difference in employment contributes to immigrants having higher levels of poverty rates than citizens. A 2023 analysis of Census Bureau data by the Migration Policy Institute found that 13 percent of immigrants had incomes below the poverty line, compared to only 7 percent of U.S.-born citizens.²⁹ Naturalized citizens were less likely to have incomes below the poverty line than non-citizen immigrants.³⁰ The same analysis also found that Latino and Black immigrants were more likely to experience poverty than white or Asian immigrants were.³¹

Figure 2

Figure 3

Difficulties affording care contribute to the rate at which immigrants skip and postpone that care. Around one in five immigrants (22 percent) reported skipping or postponing needed medical care in a 2023 KFF survey, and nearly 70 percent of those who did so reported cost or lack of coverage as a reason.³²

Figure 4

While this is about in line with the general population, it highlights how the burden of high health prices harms immigrants, as well as U.S. citizens, and how skipping or delaying medical care has real consequences: 40 percent of immigrants who reported skipping or postponing care also reported that their health got worse as a result.³³

Navigating the health care system is often harder for immigrants.

Compounding these barriers is the reality that, even for those who can access the health care system, the system is not designed with immigrants in mind. For example, about half of immigrants in the United States have limited English proficiency (LEP).³⁴ Among immigrants with LEP, more than half report that language barriers have negatively impacted their life, including more than 30 percent of LEP immigrants who report that it has made it difficult to access needed health care services.³⁵ This was even more common among lower-income LEP immigrants, highlighting the interaction of employment restrictions with other barriers to care.³⁶

Many immigrants (about one in four) also report being treated unfairly in a health care setting based on their insurance coverage, accent and English proficiency, or race and ethnicity.³⁷ Black and Hispanic immigrants were significantly more likely to report mistreatment due to these factors than white immigrants, as were uninsured immigrants and lower-income immigrants.³⁸ Figure 5 illustrates these issues.

Figure 5

The U.S. immigration and other systems also do not educate immigrants on how to navigate the health care system or their rights while doing so, which may contribute to these populations using the emergency department for medical issues that can be treated in another, lower-cost setting like a physician’s office. A September 2023 study published in American Economic Review: Insights evaluated a pilot program in New York City which connected a sample of low-income undocumented immigrants with initial primary care appointments.³⁹ The program meaningfully changed patient behavior: immigrants who received appointment assistance were more than 3.5 times more likely to have visited a primary care provider in the first three months of the program.⁴⁰ These results highlight the opportunities for and benefits of increased education among immigrant patients about how to seek care in the United States.

The issue of poor health literacy—the ability to understand health information and make informed decisions based on that information—especially burdens more marginalized immigrants. A recent study in the Journal of General Internal Medicine found that immigrants overall were more likely than U.S. citizens to have poor health literacy, and it also found that Black and Hispanic immigrants were more likely than other immigrants to have poor health literacy.⁴¹ Lower health literacy contributes to a variety of worse health outcomes, longer hospital stays, and more frequent emergency room visits.⁴² Lower health literacy can also undermine programs meant to advance health equity. For example, when the ACA marketplaces first opened, the language used on these websites was often above the English reading level of the consumers applying for coverage.⁴³ Even if patients still picked a plan, they may have chosen one that did not best fit their circumstances.

Finally, survey data shows anti-immigrant policies advanced during the first Trump administration continue to negatively impact immigrant participation in programs for which they are eligible. For example, the Trump administration issued a final rule in August 2019 which would have allowed immigration officials to consider immigrants who participated in Medicaid and other safety net programs “likely to become a public charge,” which could make them ineligible for admission to the United States or become a legal permanent resident.⁴⁴ The rule was estimated to potentially lead to the disenrollment of as many as 4.7 million noncitizen immigrants or citizens living in a family with at least one noncitizen due to immigration-related concerns.⁴⁵ This same fear was estimated to potentially deter as many as 1 million citizens who live in a household with a noncitizen immigrant from enrolling in Medicaid.⁴⁶

While the Biden administration rescinded this rule in 2021, three-quarters of the immigrants surveyed by KFF in 2023 reported uncertainty or incorrectly believing that enrolling in Medicaid or other safety net programs would jeopardize their future approval for permanent residency.⁴⁷ The Trump administration seems poised to reinstate this rule, likely increasing these concerns.⁴⁸

Recommendations: How States Can Minimize the Barriers to Care Specific to Immigrants

Reducing the barriers to health care for immigrants has benefits beyond the most fundamental one: that all people, regardless of circumstance, should have affordable, accessible, quality health care. Access to health care for these populations also improves individual and public health, helps children learn and workers be productive, and reduces the rate of uncompensated care that hospitals and other providers must face.⁴⁹ In sum, expanding access to care for immigrants helps create a healthier, stronger country, thereby benefiting not only immigrants, but also the U.S. citizens in their lives and the country as a whole. States interested in promoting health care access, equity, and affordability for immigrants have options for doing so, including the following measures:

• Expand access to affordable health coverage.
• Ensure health plans and providers support immigrants’ unique health needs.
• Work with immigrant communities to promote policy changes.

Access to health care for immigrants also improves individual and public health, helps children learn and workers be productive, and reduces the rate of uncompensated care that hospitals and other providers must face.

Expand access to affordable health coverage.

One way that states can advance health equity and improve health affordability for immigrants is through expanding their ability to access affordable health care. This approach will likely require a variety of policies to accomplish, due to the diversity among immigrant communities. In particular, undocumented and lawfully present immigrants may need different policy solutions, as the sources of their high uninsured rates are not the same.

Expanding Medicaid to all low-income adults, including eligible lawfully present immigrants, under the ACA is an instrumental step in this goal. More than one in four immigrants live in the ten states that have not yet expanded Medicaid.⁵⁰ By taking this option, states can provide health coverage to many low-income immigrants, as well as millions of low-income citizens. In addition to Medicaid expansion under the ACA, states should also create “Medicaid-like” programs for undocumented immigrants with low incomes. Nearly three-quarters of undocumented immigrants have household incomes of less than $40,000 a year; allowing these immigrants to enroll in a Medicaid-like program would therefore have an outsized impact in closing the gap in uninsured rates between undocumented immigrants and other U.S. residents.⁵¹ Importantly, these programs would be funded using state dollars, which could help allay concerns that enrollment will put immigrants at risk of federal immigration enforcement, if properly communicated.

States can implement these expansions in waves. For example, California expanded its Medicaid program to all immigrants who would be eligible based on income and residency standards in 2024, but the process took nearly a decade from the first bill to do so.⁵² In 2015, former governor Jerry Brown signed a law allowing low-income undocumented children to enroll in Medicaid, and current governor Gavin Newsom signed similar laws, expanding the program to adults ages 19 to 25 in 2019 and ages 50 and older in 2023.⁵³ Together, these laws led to more than 1.1 million low-income, undocumented Californians gaining insurance—around one-third of the uninsured population before the reforms.⁵⁴ These expansions were funded exclusively through state funds, and they represented a small percentage of overall state Medicaid spending. The initial, child-only expansion only cost $40 million out of the $18 billion appropriated for Medicaid spending that year (around 0.2 percent), and the most recent expansion only cost $614 million of the appropriated $34.9 billion for Medicaid in 2024 (around 1.75 percent).⁵⁵

These expansions were funded exclusively through state funds, and they represented a small percentage of overall state Medicaid spending.

Another option states have to connect low-income immigrants with health coverage is waiving the waiting periods for lawfully present immigrant children and pregnant people. This approach may be more attractive to states in which Medicaid expansion under the ACA or covering undocumented immigrants is less politically feasible. For these states, a more limited expansion would still ensure that many of the most vulnerable low-income immigrants would be able to access the health care they need, thereby helping them to access the coverage that the state already pays for and for which they will, with time, eventually become eligible.

In addition to programs to promote coverage for lower-income immigrants, states should insure immigrants whose incomes are too high for Medicaid eligibility. Washington State offers a model for other states in this policy approach. In 2022, Washington State received approval for a Section 1332 waiver to allow undocumented immigrants to enroll in marketplace plans beginning in the 2024 plan year.⁵⁶ Under Washington’s waiver, undocumented immigrants join citizens and lawfully present immigrants in eligibility for solely state-funded subsidies for households up to 250 percent of the poverty level (federal subsidies for marketplace coverage are not a permitted waiver topic).⁵⁷

Colorado has also developed a program aimed at insuring higher-income undocumented residents. In addition to creating a Medicaid-like program for undocumented immigrants, Colorado requires every company that sells insurance in the state to offer plans to residents regardless of immigration status.⁵⁸ The program is tied into the state’s public option and associated 1332 waiver, and the state uses the associated savings to fund state-based subsidies for residents up to 150 percent of the poverty line.⁵⁹ The state appropriated enough funds for around 11,000 of the estimated 36,000 undocumented immigrants with qualifying incomes to receive these subsidies.⁶⁰

Maryland has also received a federal waiver allowing undocumented immigrants to enroll in marketplace coverage without federal premium assistance, and the state expects to allow people to enroll in this coverage starting in November 2025 for 2026.⁶¹ The state has not established any state-funded subsidies for this coverage.⁶²

To ensure enrollment in programs that expand access to coverage for immigrant communities, states should meaningfully protect immigrants’ data privacy. While immigration status can be protected health information under federal law, states can adopt their own laws that limit sharing of immigrant status by health insurers and hospitals.⁶³ Fear of jeopardizing immigration status is a major reason that immigrants do not participate in the programs they already are eligible for,⁶⁴ and these coverage expansions should be developed with this knowledge in mind. Immigration-related fears may be further amplified under the second Trump administration following its recission of a 2011 policy that protected against enforcement activity in sensitive areas, including health care facilities.⁶⁵

Ensure health plans and providers support immigrants’ unique health needs.

While insurance coverage is a critical component of accessing affordable health care, it is not a panacea. At the root of patient struggles to afford health care is the high prices charged by many providers. Immigrants’ higher likelihood of experiencing poverty and lower rates of health coverage exacerbate the impact of unaffordably high health prices. States have many tools at their disposal to lower the cost of care, as discussed in previous TCF research.⁶⁶

Many immigrants’ experiences with the health care system undermine their ability to achieve optimal health, whether due to their immigration status directly or other aspects of their identity, such as accent or ethnicity. Similarly, immigrants often have unique health needs due to their experiences prior to immigrating. States can and should use their network adequacy and provider licensure requirements to address these issues.

Colorado has led on this issue, enacting strong requirements for culturally responsive care. Passed as part of the state’s public option law in 2021, the law requires any carrier offering a public option plan to ensure that its provider network is culturally responsive and representative of the community it serves, as well as providing a variety of training for its customer service staff.⁶⁷ As part of these requirements, carriers must also collect demographic information for both providers and patients, thereby promoting diverse networks and helping to identify gaps in networks that might have otherwise gone unnoticed.⁶⁸

Other states should adopt similar standards. For example, states should require insurers to include community health clinics (CHCs), federally qualified health centers (FQHCs), and other essential community providers (ECPs).⁶⁹ These safety-net providers all focus on medically underserved communities, and lower-income immigrants are especially likely to use a CHC as their usual source of care.⁷⁰ Adopting network adequacy requirements that include these providers can maximize the impact of the coverage expansions discussed earlier by ensuring that immigrants can continue seeing providers with whom they are comfortable and already have a patient–provider relationship.

States have broad authority to regulate health insurers, and applying these new standards across the board would ensure that these policies benefit as many patients as possible. State network adequacy requirements may be especially important in coming years: the Trump administration lowered the number of ECPs that marketplace plans were required to contract with from 30 percent of available ECPs in 2017 to 20 percent in 2018.⁷¹ States can also apply training requirements similar to Colorado’s to health care providers, benefiting patients regardless of their source of insurance coverage.

In addition to network adequacy standards, states should enshrine language access requirements. Section 1557 of the ACA prohibits discrimination in health care settings that receive federal funds, including discrimination based on language access.⁷² Unfortunately, the implementing regulations for this law have varied significantly between presidential administrations.

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For example, the Trump administration finalized a rule in 2020 which significantly rolled back Obama administration rules for section 1557 related to scope and access to interpretation and translation services for individuals with limited English proficiency.⁷³ The Biden administration revised this rule in 2024, but the Trump administration may, again, rescind this rule, and federal courts have blocked elements of section 1557 rules in the past.⁷⁴

States can enact their own language access requirements, regardless of changes at the federal level, and state laws often have significant areas for improvement regarding language access. For example, Georgia’s language access laws as of 2018 were almost exclusively focused on anti-abortion policy, while California implemented a variety of language access requirements across the health care industry in the same year.⁷⁵ Establishing meaningful language access requirements for health care providers and insurers can help ensure that patients’ limited English proficiency does not impede their access to the health care they need, and it is a crucial complement to expanding access to coverage for immigrants.

Work with immigrant communities to promote policy changes.

Finally, states should ensure that any and all of these policy changes are proactively, effectively informed by and communicated with immigrant communities. Changing eligibility for coverage programs or improving the extent to which providers and plans meet immigrants’ health needs will be less effective if beneficiaries do not know about these changes. Moreover, for immigrant communities, it is especially important to get ahead of inaccurate perceptions about how any policy change may endanger their ability to remain in the United States long-term, as well as ensuring that potentially arcane policy changes are communicated in an easily understood way.

For immigrant communities, it is especially important to get ahead of inaccurate perceptions about how any policy change may endanger their ability to remain in the United States long-term.

The Medicaid continuous coverage “unwinding” provides some examples for how to effectively communicate policy changes to immigrants. Federal law generally prohibited states from disenrolling Medicaid beneficiaries during the COVID-19 pandemic, but this requirement ended on March 31, 2023.⁷⁶ States had up to fourteen months to review and redetermine eligibility for every Medicaid beneficiary, known as the “unwinding” of the continuous coverage requirement.⁷⁷

Hoping to avoid preventable coverage losses during this process, the Protecting Immigrant Families Coalition developed a series of best practices for states:⁷⁸

• Address immigration concerns: states should communicate how immigration status may impact renewal and ask for sensitive information.
• Provide language access: states should take steps to ensure beneficiaries with LEP are supported in the redetermination process.
• Publicly report data: states should report redetermination data broken out by demographic.
• Engage stakeholders: states should include immigrant-serving organizations in the development and dissemination of unwinding information to immigrants.

While no state fully adopted the coalition’s recommendations, states which adopted more of these best practices saw notably smaller disparities in disenrollment rates between immigrants and U.S.-born residents.⁷⁹ For example, New York and California both adopted more of the coalition’s recommendations than did other states, and both states had significantly smaller disparities in disenrollments.⁸⁰ On the other hand, Texas received F grades for all four categories, and the state saw excess disenrollment among immigrants—equal to nearly 10 percent of its foreign-born population.⁸¹

Coverage expansion efforts are different than the unwinding, but the lessons learned here are likely still applicable. In particular, states should incorporate these approaches in communicating with immigrants that participating in these programs will not impact immigration status. States should include accurate information about whether lawfully present immigrants enrolling in Medicaid or marketplace coverage and undocumented immigrants using emergency Medicaid or pregnancy-related Medicaid or CHIP coverage will cause someone to be considered a public charge. States should also outline any data privacy protections they have implemented to ensure that undocumented immigrants enrolling in a Medicaid-like program are not exposed to federal immigration enforcement as a result.

Working with community-based organizations (CBOs) can also help immigrants navigate the U.S. health system. Information about public programs from trusted sources in an immigrant’s community has a greater impact on enrollment than when it comes from a state official or health provider.⁸² CBOs can often fill this role, providing accurate, trusted information about state programs, as well as assistance in applying for and reenrolling in these programs. CBOs can also provide the opportunity for immigrants to offer feedback about gaps in insurance networks, reducing any fear of retaliation that may be present when speaking with state agencies or health care providers directly.

CBOs can also provide education about using the health system in general, helping to convert coverage into care for immigrants. For example, working with CBOs to provide information on how to schedule a primary care appointment and how emergency department visits may cost more can help immigrants better operate in the U.S. health system as it currently exists. A health system education program similar to New York City’s may even help lower overall spending: immigrants who still visited the emergency department after beginning this program still saved hundreds of dollars, and patients in the program reported significantly higher rates of diabetes and blood pressure screenings, as well.⁸³ Similarly, doulas often work with CBOs to provide pregnancy support care and are especially well-equipped to work with pregnant immigrants, helping them navigate pregnancy-based health coverage as well as a maternity care system, all of which may differ greatly from their country of origin.⁸⁴

Advancing Immigrant Health Advances Health Equity for All

There are 47 million immigrants in the United States, around one-fourth of whom are undocumented. These immigrants face a variety of barriers to accessing the health care they need. Some of these barriers are the result of policies restricting enrollment in publicly supported insurance programs based on immigration status and ability to lawfully work. Other barriers stem from lower rates of health literacy and English proficiency, which make it more difficult for immigrants to meaningfully use the coverage they are eligible for.

States have the ability to address these barriers by expanding eligibility for coverage, requiring health plans and providers to better support immigrants’ health needs, and promoting these policy changes in the ways that best reach the immigrants who would benefit from them. Such efforts would be especially effective in the states which have the greatest immigrant populations: California, Texas, Florida, and New York collectively have around 54 percent of the total immigrant population.⁸⁵ Policy changes in these states will have the greatest impact for immigrants and their families.

1. Author analysis of 2023 American Community Survey one-year estimates; Jennifer Van Hook, Ariel G. Ruiz Soto, and Julia Gelatt, “The Unauthorized Immigrant Population Expands amid Record U.S.-Mexico Border Arrivals,” Migration Policy Institute, February 2025, https://www.migrationpolicy.org/news/unauthorized-immigrant-population-mid-2023.
2. United States Department of Health and Human Services, “Health Coverage for Lawfully Present Immigrants,” HealthCare.gov, accessed January 23, 2025, https://www.healthcare.gov/immigrants/lawfully-present-immigrants/.
3. Tom Jawetz, “Recent Anti-Immigrant State Laws Break New Grounds of Illegality,” Center for American Progress, July 22, 2024, https://www.americanprogress.org/article/recent-anti-immigrant-state-laws-break-new-grounds-of-illegality/.
4. Alexis Tsoukalas, “Top 5 Things to Know About SB 1718, Florida’s New Immigration Law,” Florida Policy Institute, June 28, 2023, https://www.floridapolicy.org/posts/top-five-things-to-know-about-sb-1718-floridas-new-immigration-law.
5. Amna Nawaz, Stephanie Kotuby, and Alexa Gold, “Democratic Governors Say They Are Leading State-Level Efforts to ‘Protect Democracy,’” PBS, November 13, 2024, https://www.pbs.org/newshour/show/democratic-governors-say-they-are-leading-state-level-efforts-to-protect-democracy.
6. Samantha Artiga and Petry Ubri, “Living in an Immigrant Family in America: How Fear and Toxic Stress Are Affecting Daily Life, Well-Being, & Health,” KFF, December 13, 2017, https://www.kff.org/racial-equity-and-health-policy/issue-brief/living-in-an-immigrant-family-in-america-how-fear-and-toxic-stress-are-affecting-daily-life-well-being-health/.
7. Donald J. Trump, “The Inaugural Address,” The White House, January 20, 2025, https://www.whitehouse.gov/remarks/2025/01/the-inaugural-address/.
8. Heeju Sohn and Adrian Matias Bacong, “Selection, Experience, and Disadvantage: Examining Sources of Health Inequalities among Naturalized U.S. Citizens,” SSM – Population Health 15 (2021): 100895, https://doi.org/10.1016/j.ssmph.2021.100895.
9. “Reported Tuberculosis in the United States, 2022,” Centers for Disease Control and Prevention, November 15, 2023, https://www.cdc.gov/tb/statistics/reports/2022/demographics.htm; “Hepatitis B,” Centers for Disease Control and Prevention, May 1, 2023, https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/hepatitis-b.
10. “Key Facts on Health Coverage of Immigrants,” KFF, January 15, 2025, https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/.
11. “Key Facts on Health Coverage of Immigrants,” KFF, January 15, 2025, https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/.
12. “Health Insurance Coverage of the Total Population,” KFF, accessed January 23, 2025, https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22%3A%22Location%22%2C%22sort%22%3A%22asc%22%7D.
13. Drishti Pillai and Samantha Artiga, “Employment Among Immigrants and Implications for Health and Health Care,” KFF, June 12, 2023, https://www.kff.org/racial-equity-and-health-policy/issue-brief/employment-among-immigrants-and-implications-for-health-and-health-care/.
14. Dedrick Asante Muhammad and Janessa Chu, “Racial Wealth Snapshot: Immigration And The Racial Wealth Divide,” National Community Reinvestment Coalition, February 3, 2023, https://ncrc.org/racial-wealth-snapshot-immigration-and-the-racial-wealth-divide/.
15. Department of Health & Human Services, “Health Coverage for Lawfully Present Immigrants.”
16. Hasna Chowdhury, “Immigration Healthcare and the Five Year Bar,” The Alliance for Citizen Engagement, August 23, 2022, https://ace-usa.org/blog/research/research-immigration/immigration-healthcare-and-the-five-year-bar/.
17. Akash Pillai, Drishti Pillai, and Samantha Artiga, “State Health Coverage for Immigrants and Implications for Health Coverage and Care,” KFF, January 14, 2025, https://www.kff.org/racial-equity-and-health-policy/issue-brief/state-health-coverage-for-immigrants-and-implications-for-health-coverage-and-care/.
18. Akash Pillai, Drishti Pillai, and Samantha Artiga, “State Health Coverage for Immigrants and Implications for Health Coverage and Care,” KFF, January 14, 2025, https://www.kff.org/racial-equity-and-health-policy/issue-brief/state-health-coverage-for-immigrants-and-implications-for-health-coverage-and-care/.
19. CMS News and Media Group, “HHS Final Rule Clarifying the Eligibility of Deferred Action for Childhood Arrivals (DACA) Recipients and Certain Other Noncitizens,” CMS Newsroom, May 3, 2024, https://www.cms.gov/newsroom/fact-sheets/hhs-final-rule-clarifying-eligibility-deferred-action-childhood-arrivals-daca-recipients-and-certain; Zachary Baron, “Court Blocks Enforcement Of Regulation Expanding Health Coverage Access For DACA Recipients,” Health Affairs Forefront, January 15, 2025, https://doi.org/10.1377/forefront.20250115.858221.
20. United States Department of Health and Human Services, “Health Coverage for Lawfully Present Immigrants.”
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Tags: Immigrant, health coverage, health care affordability