Research Highlights Significant Health Insurance Gaps Among Adopted Children in the U.S.

Every year, hundreds of thousands of children are adopted across the United States, yet many of these children face gaps in health insurance coverage following their adoption. A comprehensive study conducted by the University of Maryland School of Public Health, published in the journal Health Affairs, sheds light on how insurance coverage varies markedly depending on factors such as the type of adoption—domestic or international—and the citizenship status of the adoptive parent.

The research highlights that adopted children often have diverse and complex health needs, including physical and cognitive challenges. Previous studies suggested that most adopted children were insured, but this new investigation reveals a more nuanced picture. The study found a particularly alarming uninsured rate of 30.7% among internationally adopted children brought into the U.S. by non-citizens. In contrast, children adopted domestically or by U.S. citizens generally have higher coverage rates.

A key focus of the study was on four specific groups: domestic adoptees, international adoptees by U.S. citizens, international adoptees by non-U.S. citizens, and children living with relatives other than their biological parents, such as grandparents. Notably, children adopted internationally by non-U.S. citizens face the highest uninsured rates, alongside lower participation in private and public health insurance programs. These adoptive parents are often more likely to share the same race as the child, have incomes below the federal poverty line, and less homeownership compared to other groups.

The researchers analyzed data from the American Community Survey spanning 2018 to 2022, involving over three million children. Findings indicate that children living with relatives other than their biological parents also have elevated uninsured rates, around 7.3%. Conversely, children adopted domestically or by U.S. citizens are more likely to have private health insurance, with rates of 56.2% and 89.1%, respectively. Interestingly, international adoptees of U.S. citizens are often better insured than nonadopted children.

The study emphasizes that adopted children cannot be viewed as a homogeneous group, as demographic and legal differences significantly impact their access to healthcare. Policy adjustments are essential to address these disparities and ensure all adopted children receive appropriate health coverage. The authors underscore the need for tailored policy interventions to reduce insurance gaps among vulnerable adoptee populations.

Source: Medical Xpress