Public insurance expansions and the health of immigrant and native children

The costs of public insurance expansions are ordinarily justified by the claim that increased eligibility causes gains in insurance coverage, which translate into improved health care and health. This paper studies dramatic changes in public health insurance eligibility for immigrant and native children from 1998 to 2009 and finds that children's nativity status is crucial to understanding the impacts of recent eligibility expansions. I document a significantly higher degree of take-up (and less crowding out of private insurance) among first- and second-generation immigrant children than among children of U.S. natives. Eligibility expansions increased immigrant children's use of preventive and ambulatory care and decreased emergency care in hospitals, while estimated effects for children of natives are negligible. My results also suggest improvements in some health measures that would be expected to respond to preventive and ambulatory care.