Undocumented children deserve health care in New Jersey and the sooner the better Opinion


By Heather Koball, Seth Hartig and Suma Setty

For children to thrive, they need and deserve quality health care. Regular visits to the doctor keep children on schedule for their immunizations, help spot developmental delays, and detect asthma and other chronic conditions. Unfortunately, children from families without health insurance too often do not receive this care.

It is especially difficult for families of undocumented immigrant children living in New Jersey to obtain care because they are not eligible for public health insurance through Medicaid and the Children’s Health Insurance Program (CHIP).

New Jersey is taking preliminary steps to make all children eligible for public health insurance, regardless of immigration status, through the state’s Cover All Kids program. Governor Phil Murphy’s proposed budget for the next fiscal year would commit $11 million to expand program eligibility. However, coverage will not begin until January 2023.

Undocumented immigrants are part of New Jersey’s strength in diversity. Undocumented residents of New Jersey are overwhelmingly employed, hard-working, and contribute nearly $600 million in state and local taxes and more $1 billion in federal taxes that fund public health and insurance programs.

But, because of their immigration status, they are not allowed to purchase coverage through the Affordable Care Act health care marketplace. So today, the only way for undocumented immigrants to get health insurance in New Jersey is for their employer to provide it. Many, however, work in low-wage jobs that don’t offer medical coverage.

Across the country, 42% of undocumented immigrants have no health insurance, compared to only 8% of American citizens. In New Jersey, about 800,000 (33%) U.S. citizen children receive their health insurance through Medicaid or CHIP, while undocumented children are currently not eligible for this insurance.

six states currently provide publicly funded health care coverage to all eligible children, regardless of immigration status. An analysis using the study recently launched by the National Center for Children in Poverty Family Resources Simulator shows how extending Medicaid/CHIP eligibility to undocumented immigrant children benefits them and their family’s health and financial well-being.

The simulator calculates a family’s net resources over a range of income levels. Resources include income, tax credits, and government benefits, minus basic family expenses such as child care, food, medical expenses, rent, and taxes paid.

In New Jersey, undocumented immigrant children cannot receive assistance from many major public support programs, including the federal Supplemental Nutrition Assistance Program (formerly known as Food Stamps), cash for temporary assistance to needy families (often referred to as ‘welfare’), housing vouchers, child care allowances or assistance with public services.

This leaves their families far worse off than other families struggling to make ends meet. For example, a two-parent/two-child family of U.S. citizens living in poverty is eligible for assistance that helps pay for food, housing, childcare, phone and utility bills, and health insurance. . They are also eligible for the earned income tax credit and the child tax credit. None of these aids bring a luxurious existence. It just helps families get by.

Based on our simulator’s analysis, expanding access to CHIP/Medicaid for undocumented children would reduce medical costs by $1,690 per year for a poverty-level family with two children, and up to to $3,000 for a family above the poverty line. .

Being able to enroll in Medicaid/CHIP would remove a huge health care barrier for these children. It would also save the government money. Today, the health care that many of these children receive is likely to be provided in hospital emergency rooms paid for at high rates by the state – in other words, taxpayers.

It makes more health and financial sense to provide preventative care from the start, rather than limiting care to emergency or charitable care.

Today, many children who are our neighbours, friends and relatives cannot get this essential care at a time when, thanks to the ongoing pandemic, even going to school poses a risk to their health. This is especially important for children under 5 who do not yet have the opportunity to be protected by a COVID-19 vaccine.

Obtaining the health care that other children receive would enable them to participate fully in school and society, and eventually in the workplace. These children deserve nothing less. Making these children eligible now for the provisions established by the Cover All Kids legislation is the right thing to do.

Heather Koball is co-director National Center for Children in Poverty, (NCCP).

Seth Hartig is Senior Associate Researcher at NCCP.

Suma Setty is a Senior Policy Analyst at Center for Law and Social Policy (CLASP).

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