How to Expand Health Care Coverage to Undocumented Immigrants: A Policy Toolkit for State and Local Governments

This toolkit provides an overview of available policy options for state and local governments to expand health care coverage for undocumented immigrants. Approximately, 45% of undocumented immigrants\nin the United States (U.S.) are uninsured, compared to 23% of documented immigrants and 8% of U.S. citizens (1). Lack of health insurance coverage among undocumented immigrants is linked to delays seeking health care and underutilization of cost-effective health care services (2). Improving access to care for undocumented immigrants could contribute to better health outcomes and financial security in immigrant households (3).\nIn this toolkit, we review a selection of policies and programs that state and local governments have implemented to provide health care coverage to undocumented immigrants. These efforts include policies, programs, and partnerships with community organizations. We classify these efforts into three distinct categories:\n(A) State initiatives:\n1) State programs that extend eligibility criteria to Medicaid programs and CHIP.\n2) Waivers to create Uncompensated Care Pools (UCP).\n3 ) End-Stage Renal Disease (ESRD) treatment.\n(B) Local/county initiatives include:\n1) Government-run medical homes.\n2) County programs in partnership with FQHCs\nand other community clinics.\n(C) Partnerships with consular authorities and community organizations.\nWe provide a list of available policies and programs in states such as California, Texas, New Mexico, New York, Arizona, District of Columbia, Washington, Illinois and Massachusetts that can inspire similar efforts in other states and counties with a presence of undocumented immigrant population.