Left Out of the Equation: Older Immigrants and Health Insurance Coverage
Open Access
- Author:
- Reyes, Adriana Marie
- Graduate Program:
- Sociology
- Degree:
- Master of Arts
- Document Type:
- Master Thesis
- Date of Defense:
- None
- Committee Members:
- Melissa Hardy, Thesis Advisor/Co-Advisor
- Keywords:
- immigrants
aging
health insurance
inequality - Abstract:
- The older immigrant population has increased from 2.7 million in 1990 to 4.6 million in 2010 (US Census). Although Medicare provides health insurance coverage for many older people, older immigrants may not be covered by this social contract. As the number of older immigrants has increased, immigrants’ access to social welfare programs has been dramatically curtailed. Specifically, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 redefined eligibility for public programs by citizenship status. While a few states chose to address this hole in the safety-net, most states provide coverage only for immigrants who naturalize. I rely on data from the 2001, 2004 and 2008 cohorts of the Survey of Income and Program Participation for respondents aged 50 and older. Rather than limit analysis to coverage at one point in time, I use discrete-time hazard models to examine how health insurance coverage and changes in coverage are related to immigration status and factors that distinguish a heterogeneous immigrant population. Results suggest that immigrants are less likely than native-born to have health insurance at first observation, with immigrants from Latin America being least likely to be covered. Older immigrants are less likely to gain coverage and more likely to lose the coverage they have during a two to four year period of observation. Being in a state that offers supplemental insurance increases the likelihood of initially having coverage and gaining coverage, and reduces the probability that coverage is lost. Among immigrants, proficiency in the English language also increases the likelihood of initially having coverage and gaining coverage, and reduces the chance that coverage is lost. In sum, historic changes in federal policy and variation in state policy shape older immigrants’ access to health insurance even when the effects of employment, income, and other personal characteristics are taken into account.