Declining Medicaid coverage is driving these increases, adversely affecting the health care access for many children. These trends have a broad impact in the United States. One in five children in the United States is either an immigrant or has at least one immigrant parent, and many of these immigrant parents have not become citizens. Immigration and citizenship status have a profound effect on health insurance coverage and children's access to health services. However, since many workers are employed in minimum wage jobs without benefits, being employed is no guarantee of health care.
Education is a major determinant of employment opportunity.
Nearly half of noncitizen children and citizen children with noncitizen parents live in families in which the primary breadwinner has less than a high school degree, and only one-third have parents who have had at least some college. Poverty and lack of opportunity in their country of origin drove many from school at earlier ages than is typical in the United States, restricting employment opportunities in their new country. In contrast, among children whose parents are naturalized or U.S.-born citizens, more than four out of five parents have at least finished high school. Despite the booming economy during that latter 1990s, these conditions did not improve much for children in immigrant families. Employment-based health insurance coverage remained statistically unchanged between 1995 and 1997 for children in most family immigration and citizenship groups.