As the unauthorized immigrant population in the United States has grown from an estimated 1.9 million in 1988 to about 11 million today (Passel and Cohn 2011; Wasem 2009), much of the media and popular attention on unauthorized immigration has focused on adult immigrants, mainly low-skilled immigrant workers who crossed the Mexican border. Yet there are currently an estimated 1 million children (age 0-17) in the United States who lack legal immigration status (Passel and Cohn 2011). Very little information is available on role of immigration status in shaping child well-being. This study seeks to shed light on one important aspect of the well-being of undocumented children – access to healthcare.

Understanding the relationship between children’s immigration status and healthcare access is important because child health is important in and of itself, and because early life health has implications for educational performance and future earnings opportunities. Research shows that poorer health during childhood is associated with lower scores on cognitive tests, lower educational attainment, lower employment rates, and lower earnings (Currie and Stabile 2007; Case and Paxson 2010). Access to healthcare is one of the inequality-generating processes arguably most open to policy intervention (Crosnoe 2006). Therefore, understanding the relationship between legal status and access to healthcare can help to suggest policy reforms to reduce future inequalities along lines of immigration status.

In this paper, I draw on the 2002-2009 National Health Interview Survey and Medical Expenditure Panel Surveys to examine the relationship between children’s immigration status, access to health insurance, and access to healthcare. Specifically, I compare how the healthcare access of likely-undocumented immigrant children compares to that of their US-born, citizen siblings. I define “likely undocumented” siblings as foreign-born, noncitizen children from Mexico or Central or South America. By comparing citizen and noncitizen siblings in the same family, I am able to isolate the impact of immigration status from the effects of socioeconomic status and family characteristics, approximating a causal relationship between child immigration status and access to healthcare. I investigate whether there is a relationship between children's immigration status and 1) their health insurance coverage and 2) their access to various forms of basic, preventive healthcare. I further investigate whether differences in access to healthcare are accounted for by differences in access to health insurance.