Immigrants in the United States have a more difficult time accessing health care than native-born residents, and are more likely to be uninsured. 52% of recent immigrants (non-citizens residing in the U.S. for six years or less) were uninsured in 2003, compared to 15% of native citizens. Just as many non-citizens work full-time as do native born citizens, and while immigrants comprise 12% of the United States population, they make up 15% of the workforce. However, immigrants face significant barriers to obtaining employer-based insurance. Non-citizens are more likely to work in low-wage jobs in the service, construction, and agricultural industries, which are less likely to offer health insurance to their employees; 44% of service workers have access to coverage, compared with 77% of white-collar workers. In addition, 55% of non-citizens work in small firms (fewer than 100 employees), compared to 42% of native citizens. This is significant because small firms offer health benefits only 59% of the time, compared to 84% of the time in firms with more than 100 workers.

Immigrants cannot rely on government insurance either. Enrollment in health insurance among low-income legal immigrants has declined significantly since welfare reform was passed in 1996. This reform introduced the “5-year bar” restriction for legal immigrants to the United States. This restriction bars immigrants from enrolling in Medicaid or the State Children’s Health Insurance Program during their first 5 years in the United States, even if they are legal residents.

Further Resources:

• “The Role of Employer-Sponsored Health Coverage for Immigrants: A Primer,” Kaiser Family Foundation, July 2006.
• “Covering New Americans: A Review of Federal and State Policies Related to Immigrants’ Eligibility and Access to Publicly Funded Health Insurance,” Kaiser Family Foundation, November 2004.
• “Immigrants’ Health Care Coverage and Access,” Kaiser Family Foundation, August 2003.