Health insurance coverage differs sharply across immigrant groups in the United States. In the 2024 American Community Survey (ACS), 49,871,014 foreign-born people were counted in the civilian noninstitutionalized population. Of those, 25,642,588 were naturalized citizens and 24,228,426 were not U.S. citizens. The same data show a much higher uninsured burden among noncitizens than among naturalized citizens.
Immigrant health insurance statistics at a glance
- National coverage counts
- Private and public coverage
- Working-age adults
- Children under 19
- Women and access to care
- Historical city comparisons
- How to read these statistics
National coverage counts
The latest detailed citizenship-status counts in this set come from the 2024 ACS B27020 table, titled Health Insurance Coverage Status and Type by Citizenship Status, 2024: ACS 1-Year Estimates Detailed Tables. The ACS counts cover the civilian noninstitutionalized population.
Among naturalized citizens in 2024, 23,885,028 had health insurance coverage and 1,757,560 had no health insurance coverage. Among noncitizens, 17,151,725 had coverage and 7,076,701 had no coverage. These counts describe people in different citizenship categories; they are not estimates of eligibility for a particular insurance program.
The 2023 ACS provides a prior-year reference point in the 2023 B27020 table, titled Health Insurance Coverage Status and Type by Citizenship Status, 2023: ACS 1-Year Estimates Detailed Tables. It counted 47,490,095 foreign-born people in the civilian noninstitutionalized population and 22,714,901 foreign-born noncitizens. In that year, 15,869,025 noncitizens had coverage and 6,845,876 had no coverage. The 2023 table also counted 24,775,194 foreign-born people with health insurance coverage and 1,669,783 naturalized citizens without coverage.
Because these are counts rather than rates, the totals show the size of each measured group but do not by themselves show the share that was insured. Rate comparisons from Census publications provide that context for working-age adults and children.
Private and public coverage
The 2024 ACS separates coverage into private and public categories. Among naturalized citizens, 16,727,359 had private coverage and 10,147,370 had public coverage. Among noncitizens, 11,795,354 had private coverage and 6,164,713 had public coverage. These categories can overlap when a person has more than one type of coverage, so private and public counts should not be added to create a new total without the table’s definitions.
The 2023 ACS reported 9,899,077 noncitizens with private coverage and 5,612,837 with public coverage. The 2024 detailed table is the latest citizenship-status count source represented here; the 2023 figures are retained as a prior-year comparison.
| Group and year | Health insurance coverage | No health insurance coverage | Private coverage | Public coverage |
|---|---|---|---|---|
| Naturalized citizens, 2024 | 23,885,028 | 1,757,560 | 16,727,359 | 10,147,370 |
| Noncitizens, 2024 | 17,151,725 | 7,076,701 | 11,795,354 | 6,164,713 |
| Noncitizens, 2023 | 15,869,025 | 6,845,876 | 9,899,077 | 5,612,837 |
Source: 2024 ACS B27020 and 2023 ACS B27020. The ACS scope is the civilian noninstitutionalized population.
Working-age adults
The Census report Health Insurance Coverage in the United States: 2024 reports that 21.3% of foreign-born working-age adults were uninsured in 2024, compared with 8.4% of native-born working-age adults. The foreign-born category includes people with different citizenship statuses, and the gap is especially wide within that population.
In 2024, 31.8% of noncitizen working-age adults were uninsured, compared with 8.6% of naturalized-citizen working-age adults. The reported noncitizen rate was more than three times the naturalized-citizen rate. This distinction matters because a single foreign-born average combines groups with markedly different measured uninsured rates.
The Census comparison for 2022 and 2023, Percentage of Working-Age Adults Without Health Insurance Coverage by Selected Characteristics: 2022 and 2023, provides earlier measurements. In 2023, 22.3% of foreign-born working-age adults were uninsured, 32.9% of noncitizen working-age adults were uninsured, and 9.5% of naturalized-citizen working-age adults were uninsured. In 2022, the corresponding rates were 22.1%, 33.0%, and 8.8%.
| Working-age group | 2022 | 2023 | 2024 |
|---|---|---|---|
| Foreign-born | 22.1% | 22.3% | 21.3% |
| Noncitizen | 33.0% | 32.9% | 31.8% |
| Naturalized citizen | 8.8% | 9.5% | 8.6% |
Source: Census 2022–2023 comparison for 2022 and 2023; Health Insurance Coverage in the United States: 2024 for 2024. The CPS figures describe people by nativity, citizenship, and age as of the following March, so they should not be treated as identical to ACS counts.
Children under 19
Children’s coverage also varies by nativity and citizenship. In 2024, 19.4% of foreign-born children under age 19 were uninsured. The rate was 10.6% among naturalized-citizen children and 21.7% among noncitizen children.
For comparison, the 2024 rate for native-born children was 5.3%, while the rate for all children under age 19 was 6.1%. The noncitizen-child rate was therefore reported as 16.4 percentage points above the native-born rate. The foreign-born-child rate was 13.3 percentage points above the rate for all children.
The same Census publication reported lower but still distinct rates in 2023: 19.2% of foreign-born children under age 19 were uninsured, compared with 7.5% of naturalized-citizen children and 22.1% of noncitizen children. The 2023 rates were 5.1% for native-born children and 5.8% for all children under age 19.
These figures are age-specific percentages, not counts of children. They also describe insurance status at the measured period, rather than whether a child could qualify for coverage under a particular state or federal rule.
Women and access to care
Older data from the National Center for Health Statistics report on U.S. women by nativity and time in the United States add detail about coverage and care access. In the 2015–2018 National Health Interview Survey (NHIS), among women aged 50–74, 17.8% of foreign-born women were uninsured compared with 7.4% of U.S.-born women. Public health insurance covered 19.8% of foreign-born women and 13.5% of U.S.-born women. Medicare only or Medicare Advantage covered 10.6% of foreign-born women and 9.3% of U.S.-born women.
Length of residence was associated with different reported access measures in this subgroup. Among foreign-born women aged 50–74 who had lived in the United States for less than 25% of their lifetime, 33.5% were uninsured. In the same group, 22.2% had no usual place of care and 23.2% had no health-care-provider visit in the prior 12 months.
Across all foreign-born women aged 50–74 in the NHIS, 11.8% had no usual place of care, compared with 5.8% of U.S.-born women. Also, 14.1% of foreign-born women had no health-care-provider visit in the prior 12 months, compared with 8.4% of U.S.-born women. These NHIS results cover 2015–2018 and should not be presented as current national estimates.
Historical city comparisons
The ASPE report Health Insurance Coverage and Access to Care for Immigrants: Key Challenges and Policy Options includes a historical comparison for 1999–2000. In that comparison, 42% of immigrant adults in Los Angeles lacked health insurance, compared with 38% of immigrant adults in New York City.
The differences were larger for undocumented immigrant adults: 71% were uninsured in Los Angeles and 80% were uninsured in New York City. Among naturalized immigrant adults, 22% were uninsured in Los Angeles and 21% were uninsured in New York City.
| Location and group | Uninsured immigrant adults |
|---|---|
| Los Angeles, all immigrant adults | 42% |
| New York City, all immigrant adults | 38% |
| Los Angeles, undocumented adults | 71% |
| New York City, undocumented adults | 80% |
| Los Angeles, naturalized adults | 22% |
| New York City, naturalized adults | 21% |
These city figures are historical measurements from 1999–2000, not current city estimates. They are useful for showing how coverage differed by place and immigrant status in that period, but they should not be used to describe present-day conditions.
How to read these statistics
The statistics use several different populations and measurement designs. ACS counts refer to the civilian noninstitutionalized population and use citizenship-status categories. CPS figures in the Census coverage publications describe people by nativity, citizenship, and age as of the following March. NHIS results here cover women aged 50–74 during 2015–2018 and use length of U.S. residence as a share of lifetime. The ASPE comparison covers Los Angeles and New York City in 1999–2000.
For that reason, a 2024 ACS count, a 2024 CPS percentage, a 2015–2018 NHIS access measure, and a 1999–2000 city estimate answer different questions. They are descriptive statistics, not personal medical or legal advice, and they do not determine an individual’s eligibility for health insurance.