About 39.2 percent of nonelderly noncitizens (including those who are lawfully present and undocumented immigrants) do not have health insurance. Making up almost 32 percent of the total uninsured population in the US, noncitizens face several restrictions on eligibility for Medicaid, CHIP, and Marketplace coverage. Certain lawfully present immigrants need to meet a five-year residency requirement to be eligible for Medicaid and CHIP in Medicaid expansion states, and income requirements to be eligible for Marketplace PTCs in nonexpansion states. However, undocumented immigrants are never eligible for Medicaid, CHIP, and Marketplace PTCs.

In this brief, we analyze health care coverage and eligibility of nonelderly noncitizens compared with the entire nonelderly population of the US. Our estimates are for the year 2024, after the unwinding of the Medicaid continuous coverage requirement under the COVID-19 public health emergency. We discuss some state actions to expand health coverage eligibility to noncitizens and examine the eligibility of uninsured noncitizens in Medicaid expansion and nonexpansion states.

Key Takeaways

• Nonelderly noncitizens constitute about 8 percent of the total US population. However, they make up almost 32 percent of the total uninsured population in the country.
• Under some state actions to expand health coverage eligibility to noncitizens, about 16.5 percent of uninsured noncitizens gained eligibility for Medicaid, CHIP, or Marketplace PTCs. The majority, or two-thirds, of uninsured noncitizens remain ineligible for Medicaid, CHIP, and Marketplace PTCs solely because of their immigration status.
• Families with no naturalized immigrants have higher uninsured rates than families with some members as citizens.
• More than 80 percent of uninsured noncitizens are in families with at least one employed member.
• The majority of uninsured noncitizens speak Spanish, but smaller groups of noncitizens speak a wide range of other languages.