Undocumented immigrants are far less likely than any other group to have health insurance, accounting for up to a third of the growth in the uninsured population in the United States over the past two decades, according to a rand corporation study published today. in the November/December issue of health affairs magazine.
The researchers found that 68 percent of the undocumented immigrant adults they studied did not have health insurance. this compares to 17 percent of Native Americans, 23 percent of immigrants who have become citizens, and 38 percent of immigrants who are lawful permanent residents. As a group, four in 10 of those born outside the United States lacked health insurance.
The study provides the most detailed analysis to date of undocumented immigrants and health insurance.
“These findings show that if you want to do something that will have a significant impact on the uninsured problem, then you need to talk about undocumented immigrants,” said James P. Smith, a senior economist at Rand and co-author of the study. “There are pros and cons to providing insurance to the undocumented that should be openly debated. undocumented immigrants make up the problem too much to be ignored or glossed over with polite silence.”
Contrary to popular belief, undocumented immigrants in the study were less likely than other groups to be covered by public insurance such as Medicaid. This may be because recent rule changes have made it more difficult for immigrants to obtain such coverage, according to the researchers.
despite their lower income, only 8 percent of undocumented immigrants had public insurance like medicaid. this compares to 13 percent among native-born Americans and 10 percent among immigrant citizens and permanent residents. Most undocumented immigrants who had health insurance were covered through their employers, according to the Rand study.
The report also found that undocumented immigrants are more likely to be chronically uninsured. about 65 percent of undocumented immigrants in the study said they had no insurance in the past two years. this compares to 12 percent of natives, 18 percent of immigrant citizens, and 32 percent of permanent residents.
Health policy experts have assumed that undocumented immigrants represent a large number of uninsured people in the United States. But relatively little detailed information about the undocumented and health insurance has been available because survey participants are rarely asked about their legal status.
The Rand researchers analyzed data from the Los Angeles Family Neighborhood Study (LAFANS), which surveyed nearly 2,400 English- or Spanish-speaking adults throughout Los Angeles County during 2000 and 2001. Los Angeles has the community of largest immigrant in the united states.
Undocumented immigration has grown rapidly in recent years. among those who reported in 2002 that they had resided in the nation for less than five years, nearly half are undocumented immigrants, compared with 5 percent in 1970. meanwhile, the number of adults in the nation who do not have health insurance increased by 8.7 million. from 1980 to 2000.
The Rand researchers say that when they apply the rates found in their study to the nation as a whole, undocumented immigrants would account for about a third of the total increase in the number of uninsured adults nationally between 1980 and 2000.
“Since the number of undocumented immigrants has been growing rapidly, we can expect the uninsured population to grow rapidly as well,” said Neeraj Sood, an economist at Rand and another co-author of the study.
Researchers say the foreign-born were more likely to have socioeconomic factors linked to a lower rate of health insurance among all adults: less education, employment in an industry such as agriculture, where workers receive health insurance coverage, Health care less often and low income.
“Much of the reason for the low insurance rates among the foreign-born can be explained by their low socioeconomic status,” said dana goldman, director of health economics at rand and another author of the study. “But even when factors like income are considered, it doesn’t fully explain why rates are so low among the undocumented.”
Funding for the study was provided by the Robert Wood Johnson Foundation through its support of the Economic Research Initiative on the Uninsured.
the study was conducted through rand work and population, which examines issues involving the us. uu. labor markets, family and child demographics, social welfare policy, social and economic functioning of older people, and economic and social change in developing countries.
read the article on healthaffairs.org
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