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Health Insurance Coverage: Logical Versus Survey Identification of the Foreign-Born

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Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Estimating rates of public benefit use for lawful permanent residents (LPRs) is difficult given the limited availability of nationally representative data that disaggregate the foreign-born population by legal status. Using the 2008 Survey of Income and Program Participation—the only national survey that distinguishes LPRs from other non-citizens—we employ logistic regression to compare estimates of health insurance coverage for legal immigrants using two methods to infer legal status: (1) a logical approach and (2) a survey-based approach. The logical approach, relative to the survey approach, yields a higher predicted probability of having any insurance for LPRs (adjPP = 0.70) compared to the survey approach (adjPP = 0.57) and a higher likelihood of having public health insurance (adjPP = 0.26 compared to adjPP = 0.09, respectively). These findings suggest that the logical approach may overestimate lawful immigrants’ reliance on public benefits, which has implications for conclusions about recent changes to the public charge rule.

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Notes

  1. This is a limitation of the study that is partially addressed using other migration status assignment methods (i.e., the cross-sample multiple imputation, CSMI) that often rely on multiple data sources or administrative data. For an example of CSMI, see Capps et al. 2013. However, these authors also note their inability to fully distinguish among non-citizen nonimmigrant groups.

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Authors and Affiliations

  1. Department of Health Sciences, University of Missouri, 501 Clark Hall, Columbia, MO, 65211, USA

    Claire E. Altman

  2. Department of Sociology, Temple University, Philadelphia, PA, USA

    Cody Spence & James D. Bachmeier

  3. Truman School of Public Affairs, University of Missouri, Columbia, MO, USA

    Christal Hamilton

Authors
  1. Claire E. Altman
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  2. Cody Spence
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  3. Christal Hamilton
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  4. James D. Bachmeier
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Correspondence to Claire E. Altman.

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Appendix

Appendix

See Tables 2, 3 and 4.

Table 2 Logistic regression results predicting log odds of having any insurance by migration status imputation approach
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Table 3 Logistic regression results predicting log odds of having private insurance by migration status imputation approach
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Table 4 Logistic regression results predicting log odds of having public insurance by migration status imputation approach
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Altman, C.E., Spence, C., Hamilton, C. et al. Health Insurance Coverage: Logical Versus Survey Identification of the Foreign-Born. J Immigrant Minority Health 23, 606–614 (2021). https://doi.org/10.1007/s10903-020-01045-y

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  • DOI: https://doi.org/10.1007/s10903-020-01045-y

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