The crisis in immigrant health coverage has been both highlighted and exacerbated by the recent pandemic. COVID-19 has taken a heavy toll on immigrants, who are disproportionately frontline/service workers, making them particularly vulnerable to the virus. Indeed, approximately 70 percent of all immigrants in the United States (U.S.) workforce are employed as essential workers. Research affirms that foreign-born individuals are at higher risk of COVID-19 mortality, with one recent study establishing Latino(a) immigrants of working age as more than 11 times as likely to die from COVID-19 than U.S.-born non-Latino(a) individuals. High rates of uninsurance among the nation’s immigrant population are compounding COVID-19’s impact. While the Patient Protection and Affordable Care Act (ACA) led to significant gains in health coverage by insuring more than 20 million people, nearly 30 million individuals remained uninsured as of 2019. Immigrants (including “lawfully present” and undocumented individuals) make up 23 percent of the uninsured nationally. The uninsured immigrant population, which includes those who are ineligible for government sponsored coverage due to citizenship status, has few viable options for affordable health coverage, except for emergency care.

Originally prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program.