The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 provided states with the option of expanding eligibility for federally funded public insurance to low-income immigrant children within their first five years of legal residence in the United States. By 2011 twenty states and the District of Columbia had adopted that option. Using cross-sectional data from the 2003, 2007, and 2011-12 National Survey of Children's Health, we compared trends in coverage and access to care among immigrant children in states that did expand eligibility to children in states that did not. Compared to immigrant children in states that did not expand eligibility, children in states expanding eligibility experienced a 24.5 percent increase in insurance coverage, largely due to greater enrollment in public insurance. Immigrant children in states that expanded eligibility also experienced significant reductions in unmet health care needs, compared to their counterparts in nonexpansion states. Disparities relative to children in nonimmigrant families were substantially reduced in states that expanded eligibility, compared to states that did not. Expanding eligibility for federally funded public insurance to immigrant children within their first five years of legal residence in other states could improve coverage for immigrant children and might also increase access to care. © 2014 Project HOPE.

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Children's Health Insurance Program Reauthorization Act of 2009 immigrant lowest income group economics health care policy insurance health survey reduction poverty health insurance eligibility human Insurance Coverage statistics and numerical data health service controlled study financial management Eligibility Determination Health Services Needs and Demand United States cross-sectional study migrant family Humans Adolescent Infant, Newborn male Emigrants and Immigrants female preschool child Infant Child, Preschool newborn public hospital Article organization and management Financing, Government major clinical study health care access child health care medicaid public health insurance Child Health Services Health Services Accessibility health care disparity health care need child care health care delivery Child