This study was designed to identify barriers and facilitators to enrollment in public health insurance programs in immigrant adolescents and young adults. Focus groups were held in English, Spanish and Mandarin to assess barriers and facilitators to insurance enrollment. Twenty-nine students participated in the focus groups, 11 Chinese speakers, 13 English speakers and 5 Spanish speakers. They were between the ages of 18 and 24. The major factors affecting failure to enroll were lack of correct information about enrollment process and qualifications, fear of being reported to immigration, and language barriers. In general, newly arrived students had less information and many more questions. Facilitators to enrollment included perceived need for health insurance, requiring help with medical care costs, and assistance with information gathering. To increase enrollment, we suggest school-based approaches to education and enrollment, increased presence of facilitated enrollers, and increased visibility of existing informational outlets.