The Patient Protection and Affordable Care Act (ACA) will expand access to affordable health insurance for millions of Americans. In states that choose to implement the Medicaid expansion for low-income adults, Medicaid will provide an important new pathway to coverage. Yet, even in states that choose to expand Medicaid a significant proportion of the low-income nonelderly adult population will be excluded from the Medicaid expansion due to their immigration status. Legal permanent residents, in most circumstances, are ineligible for Medicaid benefits for the first five years during which they reside legally in the U.S. and unauthorized immigrants are excluded from Medicaid coverage. This brief provides the first state-specific estimates of the number of uninsured low-income adults that will potentially be excluded from the Medicaid expansion because of their immigration status. Other researchers have produced national estimates of the characteristics of the unauthorized, state level population estimates of the unauthorized, and state level characteristics of those eligible for the Medicaid expansion (see "Contribution to Existing Research" section). Unlike these previous estimates that start with the number of foreign born and subtract out the legally resident population to arrive at an estimate of the number of unauthorized immigrants, we start by creating a regression model of legal status using person-level data from the Survey of Income and Program Participation (SIPP). We use the SIPP because it is the only national level survey that includes a question on immigration status. However, since the SIPP does not have enough sample size to support state-specific analyses and the American Community Survey (ACS) does, this paper uses the regression model in the SIPP to impute legal status into the ACS (see "Data and Methods" section).
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