Legal status and health disparities: An examination of health insurance coverage among the foreign-born

Abstract

Objective: This paper employs a statistical matching procedure to impute the legal status of foreign-born adults in US Census surveys in order to estimate migration status disparities in health insurance coverage. Methods: Using data from the Survey of Income and Program Participation, we impute the legal/citizenship (migration) status of immigrants in the National Health Interview Survey. Results: Results from the pooled data document disparities in health insurance coverage among four citizen/legal status groups: naturalized citizens, lawful permanent residents, legal nonimmigrants, and unauthorized immigrants. Naturalized citizens had the highest rate of health insurance coverage, followed by legal immigrants, legal nonimmigrants, and unauthorized immigrants. Contribution: The paper presents revised pre-Affordable Care Act (ACA) estimates of health insurance coverage among the foreign-born that are crucial for evaluating the impact of the ACA on reducing or exacerbating disparities in health coverage among migration status groups.

Keywords

• health insurance
• immigration
• imputation
• legal status