September 2025 | Mandi Spishak-Thomas & Allison Oh | Covering Uninsured Children: State Solutions for Immigrant Children
As of 2023, nearly 3 million children in the United States remained uninsured, largely due to immigration-related exclusions in public insurance programs like Medicaid and the Children’s Health Insurance Program (CHIP). In response, state policymakers have sought ways to close the gap on children’s coverage. Fourteen states and the District of Columbia have used only state funds to provide health insurance coverage to income-eligible children without legal immigration status. While HR1/OBBBA originally proposed withholding billions in funds from states with benefits for immigrants without legal status, this provision was stricken following senate parliamentarian review. Still, given the political climate, it is unlikely OBBBA will be the last word on threats to states with generous health care policies. In this post, we examine the policies of these 15 jurisdictions to provide an overview for states considering similar legislation.