Original Investigation

State-Funded Health Insurance Expansion for Noncitizen Immigrants and Hospital Uncompensated Care

JAMA Network Open 10.1001/jamanetworkopen.2026.31331

September 09, 2026 at 11:00 AM EDT

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In this cohort study of hospitals in Illinois and comparison states, the HBIA and HBIS programs were associated with significant reductions in hospital bad debt and suggestive reductions in charity care. State-funded health insurance expansions for undocumented and noncitizen immigrants were associated with improved hospital financial stability and may help address persistent gaps in insurance coverage among immigrants.

Corresponding Author: Aresha Martinez-Cardoso, PhD, Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, MC2000, Chicago, IL 60637 (areshamc@uchicago.edu).

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