OBJECTIVES Expansion of insurance eligibility is associated with positive health outcomes. We compared uninsurance and health care utilization for (1) all children, and (2) children in immigrant families (CIF) and non-CIF who resided inside and outside of the seven US states/territories offering public health insurance to children regardless of documentation status ("extended-eligibility states/territories"). METHODS Using the cross-sectional, nationally representative National Survey of Children's Health-2019, we used survey-weighted, multivariable Poisson regression to assess the association of residence in nonextended- versus extended-eligibility states/territories with uninsurance and with health care utilization measures for (1) all children, and (2) CIF versus non-CIF, adjusting for demographic covariates. RESULTS Of the 29 433 respondents, the 4035 (weighted 27.2%) children in extended- versus nonextended-eligibility states/territories were more likely to be CIF (27.4% vs 20.5%, P < .001), 12 to 17 years old (37.2% vs 33.2%, P = .048), non-White (60.1% vs 45.9%, P < .001), and have a non-English primary language (20.6% vs 11.1%, P < .001).The relative risk of uninsurance for children in nonextended- versus extended-eligibility states/territories was 2.0 (95% confidence interval 1.4-3.0), after adjusting for covariates. Fewer children in extended- versus nonextended-eligibility states/territories were uninsured (adjusted prevalence 3.7% vs 7.5%, P < .001), had forgone medical (2.2% vs 3.1%, P = .07) or dental care (17.1% vs 20.5%, P = .02), and had no preventive visit (14.3% vs 17.0%, P = .04). More CIF than non-CIF were uninsured, regardless of residence in nonextended- versus extended-eligibility states/territories: CIF 11.2% vs 5.7%, P < .001; non-CIF 6.1% vs 3.1% P < .001. CONCLUSIONS Residence in nonextended-eligibility states/territories, compared with in extended-eligibility states/territories, was associated with higher uninsurance and less preventive health care utilization.

中文翻译：

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无证儿童符合医疗补助资格地区的保险和医疗保健结果。

目标 保险资格的扩大与积极的健康结果相关。我们比较了 (1) 所有儿童和 (2) 居住在向儿童提供公共健康保险的美国七个州/地区境内和境外的移民家庭 (CIF) 和非 CIF 儿童（无论其证件如何）的无保险和医疗保健利用率状态（“扩展资格州/地区”）。方法 利用具有全国代表性的横断面全国儿童健康调查 - 2019 年，我们使用调查加权、多变量泊松回归来评估居住在非扩展资格州/地区与扩展资格州/地区与未保险和医疗保健利用措施之间的关系对于 (1) 所有儿童，以及 (2) CIF 与非 CIF，调整人口统计协变量。结果 在 29 433 名受访者中，与非扩展资格州/地区相比，4035 名（权重为 27.2%）儿童更有可能成为 CIF（27.4% vs 20.5%，P < .001），年龄为 12 至 17 岁（ 37.2% vs 33.2%，P = .048），非白人（60.1% vs 45.9%，P < .001），并且主要语言非英语（20.6% vs 11.1%，P < .001）。调整协变量后，非扩展资格州/地区与扩展资格州/地区的儿童不保险的相对风险为 2.0（95% 置信区间 1.4-3.0）。与非扩展资格州/地区相比，延长资格州/地区未投保（调整后患病率 3.7% vs 7.5%，P < .001）、放弃医疗（2.2% vs 3.1%，P = .07）或牙科护理（17.1%）的儿童较少对比 20.5%，P = .02），并且没有进行预防性就诊（14.3% 对比 17.0%，P = .04）。无论居住在非扩展资格州/地区与非扩展资格州/地区，CIF 人数多于非 CIF 人未投保：CIF 11.2% vs 5.7%，P < .001；非 CIF 6.1% 与 3.1% P < .001。结论 与扩展资格州/地区相比，居住在非扩展资格州/地区与更高的未保险率和更少的预防性医疗保健利用相关。