Throughout the COVID-19 pandemic, we have championed multiple legislative packages (i.e., the American Rescue Plan Act) that help bridge the gap in access to health care for millions of people. Noncitizen immigrants, however, continue to be excluded from health care coverage despite disproportionately high rates of COVID-19 infections, due to many in their communities holding jobs concentrated in frontline and essential industries, as well as other barriers. Due to federal restrictions, many noncitizen immigrants are ineligible for programs like Medicaid, Medicare, the Children’s Health Insurance Program (CHIP) and coverage through the Affordable Care Act (ACA) Marketplaces, leaving them vulnerable to continued health disparities amidst the pandemic.  

In our latest case studies, we explore how state advocates sought to improve health coverage and access for immigrants in Illinois and Washington State between 2019 and 2021. Presently, across several states, health and immigrant rights advocates continue a call to action to impact noncitizen immigrants’ access to care and promote health equity. In recognition of the glaring gap in coverage, states have forged ahead with state-funded innovative solutions for immigrant populations – working to ensure that their health care needs are met.  

Throughout 2021, several states sought to provide immigrants’ coverage through the use of state funds. Here’s a list of some states that made progress toward improving immigrants access to health care:  

  • New Jersey passed legislation that will expand comprehensive Medicaid-like coverage to all income-eligible children regardless of their immigration status.  

  • Maine, Vermont and Connecticut1 passed state budgets or legislation that will expand Medicaid-like coverage in 2022 and in 2023 to income-eligible children and pregnant people regardless of their immigration status. 

  • Virginia passed legislation to remove the 40-quarters rule2 and a state budget that includes coverage for pregnant people regardless of their immigration status.  

  • Colorado passed legislation to implement a Reproductive Health Care Program that will provide contraceptives and counseling services to all eligible people regardless of their gender identity and immigration status. Colorado also became the third state to pass a public option bill, but the first state that will offer coverage to undocumented people through this pathway. 

  • Oregon passed legislation that will expand Medicaid-like coverage in 2022 for income-eligible adults subject to appropriated state-funds. 

  • Illinois and California authorized Medicaid-like coverage for all income-eligible older adults regardless of their immigration status and 12-months postpartum coverage for postpartum people.  

These victories were possible because of advocates, organizers, and community members’ determination and strategic campaign executions to address and reduce health disparities. Our newest case studies offer advocates insights from advocates who have achieved incremental successes in coverage pathways for immigrant communities historically left out of coverage options. They explore the coverage expansion efforts and most impactful advocacy tactics utilized by advocates in Illinois and Washington State to make health care more accessible for all residents regardless of immigration status in their respective state.  

As we continue to see a rise in victories, we are offered a glimpse at what is possible to push for and what can be achieved during the 2022 state legislative sessions and beyond to eliminate health disparities for immigrants and their families. 


1 Connecticut’s expansion is currently only for children between the ages of 0-8 years old regardless of immigration status. 

2 Virginia was one of six states that added an additional barrier to Medicaid coverage for lawful permanent residents, requiring a 10-year work history in the U.S. also known as the “40-Quarter Rule.”