Children in immigrant families now comprise more than one-fifth of all children in the United States. Low-income children in immigrant families, particularly children who are themselves immigrants, are more likely to be uninsured and to have poor access to health care than low-income children from native-born families. Differences in insurance coverage are related to restricted eligibility for public insurance coverage and to limited access to employer-sponsored insurance. The combination of poor insurance coverage, language barriers, and other factors contributes to reduced access to medical care services for immigrant children. This article reviews the literature, examines some common misconceptions regarding immigrants and the nation's health care problems, and describes potential federal, state, and local policies that could improve or weaken children's access to insurance and health care.