Original Investigation

Health Care Access Outcomes for Immigrant Children and State Insurance Policy

JAMA Network Open 10.1001/jamanetworkopen.2025.45826

December 01, 2025 at 11:00 AM EST

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Are there associations of state-level policies for insurance eligibility for immigrant children with improved health care access outcomes for this population?In this cross-sectional study of 277 386 children, immigrant compared with US-born children had significantly worse outcomes for uninterrupted health insurance, access to primary care, access to sick care, having foregone medical care, and having difficulty with referrals. More inclusive state-level insurance eligibility policies for immigrant children were associated with improved access to health insurance and primary care.These findings suggest that more inclusive state insurance eligibility policies for immigrant children may improve health care access outcomes for this population.

Corresponding Author: Katherine E. Douglas, MD, Division of Emergency Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 (katherine.douglas@childrens.harvard.edu).

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