CHIP-ing Away at Health Disparities: Has State-Provided Health Insurance Reduced Race- and Nativity-Based Differences in Health Care Utilization among US Children?

Abstract

Although recent legal permanent residents and undocumented immigrants are generally barred from accessing public health insurance, some US states cover immigrant children through the Children’s Health Insurance Program (CHIP). In this study, we examine the contextual effect of US state health insurance eligibility policy, particularly with respect to immigrant children, on race/ethnic and nativity-based disparities in children’s routine health care. Utilizing our original data on state CHIP eligibility policies and child-level data from the Survey of Income and Program Participation, we find that a significant portion of between-state variation in children’s routine health care results from diversity in CHIP eligibility rules for poor and foreign-born children. Immigrant-specific disparities are reduced when states do not require five years of residency for CHIP participation.