Access to affordable health coverage and healthcare is critical for pregnant individuals and translates to better outcomes for their children. Immigrants who are subject to Medicaid's five-year bar or who are undocumented are less likely than U.S. citizens or those with a legal status to have health coverage, including adequate prenatal care, in part due to more limited interactions with the healthcare system as a result of previous public charge and other exclusionary immigration policies. Healthcare for all immigrants is imperative to advancing health equity and reducing disparities between immigrant and U.S. born individuals.
Under federal regulations, states may provide pregnancy-related care through the Children's Health Insurance Program (CHIP) state plan to targeted low-income children from conception to birth (the so called "unborn child" option). This option–referred to in this brief as the CHIP coverage option for pregnant immigrants and their children–enables states to provide prenatal, labor and delivery, and postpartum services to pregnant individuals, regardless of immigration status. As of January 2021, approximately one-third of states had pursued this coverage mechanism, meaning many more states could still elect to draw down available federal funding to strengthen access to care for their pregnant residents and prioritize the health of children who will become U.S. citizens at birth. This issue brief–the second in a series, "Supporting Health Equity and Affordable Health Coverage for Immigrant Populations"–offers considerations for policymakers around the CHIP coverage option for pregnant immigrants and their children, regardless of immigration status.