Abstract: Latinx children now live in a wider array of U.S. geographic areas than in the past, including both established and new areas of Latinx settlement. This geographic heterogeneity could be consequential for Latinx children’s health care access, with prior research suggesting increased health access barriers for Latinx children in new versus established areas of settlement. Merging public-use county-level data with restricted individual-level health data from the National Health Interview Survey (2010–2014), we quantitatively examine how three health access indicators—health insurance coverage, delayed care, and usual place of care—differ among children (ages 4–17) in Latinx immigrant, Latinx U.S.-born, White U.S.-born, and Black U.S.-born families (n = 89,994) across established, fast-growing hub, new, and minor Latinx destination counties. We also examine the potential roles of local immigrant hostilities and health care resources in contributing to health access differences across destinations. In fully adjusted models, children in new destinations are less likely to have health insurance than peers in established destinations, and this disparity is even wider for Latinx children of immigrants. Adjusted model results also show that children in new destinations are more likely to have delayed care than those in established destinations, and children in these four groups in new destinations, fast-growing hubs, and minor destinations are more likely to have no usual place of care than peers in established destinations. Our results are consistent with prior work suggesting that more health care access barriers exist for children, particularly Latinx children of immigrants, in new versus established Latinx destinations.