For the first time since 1996, the Children?s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) gave states the option to provide federally funded Medicaid and CHIP coverage to low-income, lawfully residing immigrant children and pregnant women, without a five-year waiting period. Since CHIPRA passed, around 20 states [as seen on our CHIPRA state coverage map] have taken advantage of the new federal dollars available to begin offering this coverage.

The Center is working on a Multi-State Initiative to urge more states to exercise the CHIPRA option. Building on the momentum of comprehensive health reform, the Center?s Multi-State Initiative would continue progress toward equitable and affordable access to healthcare for immigrants. The initiative is an education and advocacy program designed to motivate children?s health advocates, immigrant groups, and other partners to work toward eliminating the five-year waiting period.

In the five states CIHJ will focus on ? Missouri, Kansas, Indiana, Michigan, and Kentucky ?as many as 17,000 lawfully residing immigrant children could qualify for Medicaid or CHIP, but remain ineligible because of the five-year waiting period. Should states choose to exercise this option, they would remove an unjust barrier to healthcare and begin providing much-needed coverage to thousands of low-income immigrant children and pregnant women who have, until now, been marginalized under U.S. policy. By investing now in equitable access to health coverage for lawfully residing immigrant children and pregnant women, states can secure millions of dollars in federal matching funds to move toward covering all its uninsured.

It is true that current economic troubles and its subsequent troubled budget climate is a barrier for states to expand coverage to its legal immigrant residents. Despite this financial obstacle, however, the expanded coverage will provide benefits beyond short-term improved health:

? Providing prenatal care for women can produce substantial savings in hospital care costs by reducing unnecessary hospitalizations; such care reduces the risk of delivering low-birth-weight or premature infants.

? The recently passed health care reform only provides subsidies to low and middle income legally residing immigrants beginning in 2014, creating a situation in which these legal immigrants and their children will have few alternative means for obtaining affordable and quality health care during the next few years. Particularly in adolescent health, years without proper health care can result in a lifetime of increased health risks, uncompensated care costs that the state or hospitals will be forced to pay in the future. Covering these children and pregnant women now is a solution to their potentially bleak situation during the next few years.