Introduction The Patient Protection and Affordable Care Act (ACA) substantially expanded health insurance coverage in the US and improved access to care.1-3 However, undocumented immigrants and some noncitizen immigrants were explicitly excluded from ACA expansions.4 As of 2023, half of likely undocumented adults and 18% of lawfully present immigrant adults reported being uninsured compared with 6% of naturalized and 8% of US-born citizens.5 The exclusion of immigrants from coverage has...