Adults under the age of 65 who are noncitizens are expected to represent about one-third of the country’s 27 million uninsured in 2024 — even though this group only accounts for 8% of the total nonelderly population in the U.S., a new report showed.
The report, published Thursday, was conducted by the Urban Institute and funded by the Robert Wood Johnson Foundation. For the analysis, the researchers used the Urban Institute’s Health Insurance Policy Simulation Model, which estimates how healthcare policy options will affect cost and coverage.
It comes after the Health and Human Services (HHS) proposed a rule that would permit Deferred Action for Childhood Arrivals (DACA) recipients — also known as Dreamers — to apply for coverage through the Health Insurance Marketplace or through their state Medicaid organization. HHS predicts the rule could lead to 129,000 DACA recipients gaining coverage. The Urban Institute’s analysis, however, does not include the effects of the proposed rule.
The researchers found that in 2024, the uninsurance rate for nonelderly people who aren’t citizens will be 39.2%, about four times higher than it is for the entire U.S. population at 9.8%.
“As the uninsurance rate has declined, noncitizens comprise a growing share of those without coverage,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, in a news release. “The recent proposed rule regarding DACA recipients illustrates the need for expanding eligibility regardless of immigration status if we want to attain universal coverage.”
The report also showed that 36% of those who are noncitizens have employer-sponsored insurance, lower than the total nonelderly population in the U.S. at 54.4%.
In addition, more than 80% of uninsured noncitizens have at least one family member who is employed. However, many aren’t working for companies with employer-sponsored insurance, according to the Urban Institute.
This population is also less likely to have insurance through the government: just 16.5% of those who are uninsured and noncitizens are eligible for Medicaid, CHIP or subsidized Marketplace coverage. Two-thirds of this group are ineligible because of their immigration status.
“Despite some efforts to cover certain lawfully present noncitizens and the availability of Marketplace options, only 16.5% of uninsured noncitizens gained eligibility for Medicaid, CHIP, or Marketplace premium tax credits,” said Matthew Buettgens, senior fellow at the Urban Institute, in a statement. “States have several options to extend coverage to noncitizens and undocumented immigrants and expand overall health coverage in the United States.”
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