New research shows noncitizen immigrants are far less likely to have insurance, see a doctor, or afford care when they need it most.
Imagine living in the same country for years. You pay taxes. You raise a family. Maybe your children are even U.S. citizens. But when you get sick, you have nowhere to turn — no insurance, no regular doctor, and no way to pay the bill if something goes wrong.
This is the reality for millions of noncitizen immigrants across the United States, according to a new study from Johns Hopkins Bloomberg School of Public Health.
What the Study Found
Researchers looked at data from more than 76,000 adults, collected through the National Health Interview Survey from 2019 to 2023, and published their findings in Health Affairs Scholar. The results reveal a big gap between citizens and noncitizens when it comes to healthcare.
Immigrants who are not U.S. citizens are more likely to go a full year without seeing a doctor, more likely to have no regular place to go for care, and more likely to worry seriously about paying medical bills if they get sick or hurt. They are also far less likely to have any health insurance at all.
The Numbers Tell the Story
- Nearly one in four noncitizens has no health insurance — compared to just 3% to 4% of U.S.-born citizens and naturalized citizens. That’s a huge gap.
- Noncitizens are 21% more likely to have skipped a doctor’s visit in the past year.
- They are 44% more likely to have no regular doctor or clinic to go to.
- And they are 33% more likely to be seriously worried about affording medical care if they got sick or injured.
Why This Is Happening
Before July 2025, immigrants who were lawfully living in the U.S. could qualify for health coverage through the Marketplace or Medicaid, as long as they met the same rules as citizens and had lived in the country for five years. But that support is shrinking.
Starting in October, new federal rules will make it harder for immigrants to qualify for Medicaid and Marketplace coverage. Refugees, asylees, and survivors of human trafficking will lose access to these programs completely.
In simple terms: the safety net that used to help many noncitizens get healthcare is getting smaller, right when people need it most.
Why Becoming a Citizen Makes a Real Difference
Here’s the part of the study that matters most: naturalized citizens don’t face these same problems. Their insurance coverage and access to care look much more like U.S.-born citizens. Becoming a citizen doesn’t just come with a right to vote — it comes with real, practical benefits for your health and your wallet:
- Better access to health insurance. Citizens are far more likely to be covered, with insurance rates similar to people born in the U.S.
- More consistent care. Citizens are more likely to have a regular doctor and get checkups before small problems become big, expensive ones.
- Less financial fear. Citizens worry far less about being unable to pay for care if something happens.
- Protection from future policy changes. As eligibility rules for noncitizens keep changing, citizenship offers something more stable and permanent.
What You Can Do Right Now
If you are a lawful permanent resident (green card holder), you may already be eligible to apply for U.S. citizenship. Here’s what that generally requires:
- Holding a green card for at least 5 years (or 3 years if you’re married to a U.S. citizen)
- Living in the U.S. continuously and being physically present for enough of that time
- Showing good moral character
- Passing an English and civics test (with some exceptions and simpler tests for older applicants)
You don’t have to figure this out alone:
- Fee waivers are available if you qualify based on income, through the official government process.
- Help preparing your application is available through services like Immigration Direct’s N-400 preparation service, which can guide you through the paperwork.
- Free assistance is also offered by many nonprofit and community organizations that run naturalization workshops and legal screenings.
Bottom Line
Healthcare access for noncitizens is getting harder, not easier. But if you’re eligible, applying for citizenship is one of the clearest, most direct ways to protect your health and your future.
If you think you might be eligible, don’t wait — start your citizenship application today.
