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Health Insurance Coverage of the Children of Immigrants in the United States

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Abstract

Objectives: This study assesses the health insurance coverage of children of immigrants in the United States and variations among immigrant groups. Method: The study uses data from the March supplements of the 1994 and 1996 Current Population Survey to compare health insurance coverage of children who report foreign parentage. Separate logistic regressions are conducted to estimate the likelihood of being covered by any insurance, public insurance, and private insurance. Results: 27.3% of all children of immigrants are without health insurance, 34.1% are on public insurance, and 44.3% have private insurance. Foreign-born children who have not yet become U.S. citizens are the most likely to be without health insurance (38.0%). Many of these children are not covered because their parents are unable to find jobs that provide coverage and Medicaid fails to enroll as many of them as possible. Overall, the children's chances of being covered by any health insurance vary little according to when their parents came to this country. However, children of recent immigrants are more likely to rely on public health insurance (40.1% vs. 24.8%) and less likely to be covered through private sources (36.8% vs. 60.6%) than those of established immigrants. Among immigrant groups, children of Haitian (48.4%) and Korean (45.3%) immigrants are at the highest risks of being uninsured. Both children of the Dominican Republic (65.9%) and Laos (83.3%) report high rates of public insurance coverage. Conclusions: Greater disparity in health insurance coverage among children of immigrants is expected once the new welfare reform bills take effect. In particular, noncitizen children, children of recent immigrants, illegal immigrants, and Dominican Republican immigrants will be affected most. Efforts aimed at reducing the harm should target these vulnerable groups.

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REFERENCES

  1. Fix M, Zimmerman W. Educating immigrant children: Chapter 1 in the changing city. Washington, DC: Urban Institute, 1993.

    Google Scholar 

  2. Portes A, Zhou M. The new second generation: Segmented assimilation and its variants. Ann Am Acad Polit Social Sci 1993;530:74–96.

    Google Scholar 

  3. Board on Children and Families, Commission on Behavioral and Social Sciences and Education, National Research Council, Institute of Medicine. Immigrant Children and their families: Issues for research and policy. Future Children 1995;5(2):72–89.

    Google Scholar 

  4. Stephen EH, Foote K, Hendershot GE, Schoenborn CA. Health of the foreign-born population: United States, 1989–1990. Advance Data 1994;241.

  5. Leclere FB, Jensen L, Biddlecom AE. Health care utilization, family context, and adaptation among immigrants to the United States. J Health Social Behav 1994;35:370–84.

    Google Scholar 

  6. Thamer M, Richard C, Casebeer AW, Ray NF. Health insurance coverage among foreign-born US residents: The impact of race, ethnicity, and length of residence. Am J Public Health 1997;87:96–102.

    Google Scholar 

  7. Guendelman S, Schwalbe J. Medical care utilization by Hispanic children: how does it differ from black and white peers? Med Care 1986;24:925–37.

    Google Scholar 

  8. Monheit AC, Cunningham PJ. Children without health insurance. Future Children 1992;2(2):154–70.

    Google Scholar 

  9. The Personal Responsibility and Work Opportunity Act of 1996. Public Law No. 104–193(August 22, 1996).

  10. The Illegal Immigration Reform and Immigrant Responsibility Act of 1996. Public Law No. 104-208(September 30, 1996).

  11. Waxman J, Alker J. The impact of federal welfare reform on Medicaid. [on line] Washington, D.C.: Families USA [cited August 19, 1996]. http://epn.org/families/faimwb.html

    Google Scholar 

  12. National Health Law Program. Health related provisions in the Illegal Immigration Reform and Immigrant Responsibility Act of 1996. [on line] [cited October 8, 1996]. http://www.healthlaw.org/immigrat.html

  13. National Health Law Program. An analysis of welfare changes and their effects on Medicaid recipients. [on line] [cited August 12, 1996]. http://www.healthlaw.org/analyses.html

  14. Martin P. Proposition 187 in California. Int Migrat Rev 1985;29(1):255–263.

    Google Scholar 

  15. Immigration and Naturalization Service. Immigration fact sheet. [on line] Washington, D.C. [cited August 5, 1996]. http://www.ins.usdoj.gov/public/299.html

  16. Immigration and Naturalization Service. Immigration to the United States in fiscal year 1996. Annual Statistical Reports. Washington, D.C., 1997.

  17. Cobb-Clark DA. Do immigrants have adequate health insurance? The implications of foreign-born status for health insurance coverage. Paper presented at the annual meeting of the Population Association of America, Washington. D.C., March 1991.

  18. Foley J, Snider S, Boyce S. Sources of health insurance and characteristics of the uninsured: Analysis of the March 1992 Current Population Survey. EBRI Issue Brief, Washington, D.C.: Employee Benefit Research Institute, 1993.

    Google Scholar 

  19. Bennefield RL. U.S. Bureau of the Census. Current Population Reports, Series P60-195, Health Insurance Coverage: 1995. Washington. D.C.: U.S. Government Printing Office, 1996.

    Google Scholar 

  20. Huang F. Asian and Hispanic immigrant women in the work force: Implications of the United States immigration policies since 1965. Ph.D. dissertation. New York: Garland Publications, 1997.

  21. U.S. Department of Commerce. Bureau of the Census. Annual demographic survey (March supplement), Note 4. [on line] [cited October 1, 1996]. http://www.bls.census.gov/cps/ads/1995/susrnot4.html

  22. U.S. Department of Commerce. Bureau of the Census. The Current Population Survey: design and methodology. Technical Paper 40, Washington, D.C.: Bureau of the Census, 1978.

    Google Scholar 

  23. Baugher E, Lamison-White L. U.S. Bureau of the Census. Current Population Reports, Series P60-194, Poverty in the United States: 1995. Washington, D.C.: U.S. Government Printing Office, 1996.

    Google Scholar 

  24. U.S. Department of Commerce. Bureau of the Census. Annual demographic survey (March supplement, changes in health insurance questions 1994 to 1995). [on line] [cited October 1995] http://www.bls.census.gov/cps/ads/1995/susrnot3.html

  25. Swartz K. Changes in the 1995 Current Population Survey and estimates of health insurance coverage. Inquiry 1997;34:70–79.

    Google Scholar 

  26. McGuinness RA. Bureau of Labor Statistics. Redesign of the sample for the Current Population Survey. Employ Earn 1994;14(5):7–10.

    Google Scholar 

  27. Hosmer DW Jr, Lemeshow S. Applied logistic regression. New York: John Wiley & Sons, 1989.

    Google Scholar 

  28. Jensen L, Chitose Y. Today's second generation: evidence from the 1990 U.S. Census. Int Migrat Rev 1994;28(4):714–35.

    Google Scholar 

  29. Ladenheim K. Comment: health insurance coverage of foreign-born US residents—The implications of the new welfare reform law. Am J Public Health 1997;87:96–102.

    Google Scholar 

  30. Borjas GJ. Assimilation, changes in cohort qualities, and the earnings of immigrants. J Labor Econ 1985;3(4):463–89.

    Google Scholar 

  31. Ku L, Coughlin TA. How the new welfare reform law affects Medicaid. [on line] Washington, D.C.: The Urban Institute. [cited April 22, 1997]. http://newfederalism.urban.org/html/anf_a5.htm

    Google Scholar 

  32. Borjas GJ. Friends or strangers: The impact of immigration on the US economy. New York: Basic Books, 1990.

    Google Scholar 

  33. Jasso G, Rosenzweig MR. What's in a name? country-of-origin influences on the earnings of immigrants in the United States. Res Human Capital Develop: Migrat Human Capital Develop 1986;4:75–106.

    Google Scholar 

  34. Jasso G, Rosenzweig MR. Sponsors, sponsorship rates and the immigration multiplier. Int Migrat Rev 1989;23(4)856–88.

    Google Scholar 

  35. General Accounting Office. Immigration: The Future Flow of Legal Immigration to the United States. GAO/PEMD-88-7, Washington D.C.: Government Printing Office, 1988.

    Google Scholar 

  36. Siddharthan K. Health insurance coverage of the immigrant elderly. Inquiry 1991;28:403–12.

    Google Scholar 

  37. National Center for Health Statistics. Health, United States, 1994. Hyattsville, Maryland: Public Health Service, 1995.

    Google Scholar 

  38. ILAB (U.S. Department of Labor, Bureau of International Labor Affairs). Characteristics and labor market behavior of the legalized population five years following legalization. Washington, D.C., 1996.

  39. Lewit EM, Baker LS. Health insurance coverage. Future Children 1995;5(3):192–204.

    Google Scholar 

  40. Winterbottom C, Liska DW, Obermaier KM. State-Level Databook on Health Care Access and Financing, 2nd ed. Washington, D.C.: Urban Institute, 1995. Appendix 3.

    Google Scholar 

  41. Mittlbock M, Schemper M. Explained variation for logistic regression. Stat Med 1996;15:1987–1997.

    Google Scholar 

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Huang, FY. Health Insurance Coverage of the Children of Immigrants in the United States. Matern Child Health J 1, 69–80 (1997). https://doi.org/10.1023/A:1026266205885

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