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January 2005, Vol 95, No. 1 | American Journal of Public Health 109-116
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2003.028514

RESEARCH AND PRACTICE

Immigration Status and Health Insurance Coverage: Who Gains? Who Loses?

Julia C. Prentice, PhD, Anne R. Pebley, PhD and Narayan Sastry, PhD

Julia C. Prentice is with the Center for Health Quality, Outcomes and Economic Research (CHQOER) at the Bedford Veteran Affairs Medical Center. She completed this work while at the Department of Community Health Sciences, University of California, Los Angeles. Anne R. Pebley is in the Department of Community Health Sciences, University of California, Los Angeles. Anne R. Pebley and Narayan Sastry are with the RAND Corporation, Santa Monica, Calif.

Correspondence: Request for reprints should be sent to Julia C. Prentice, CHQOER, Bedford VAMC, 200 Springs Rd (152), Bedford, MA 01730 (e-mail: jprentic{at}bu.edu).

Objectives. We compared health insurance status transitions of nonimmigrants and immigrants.

Methods. We used multivariate survival analysis to examine gaining and losing insurance by citizenship and legal status among adults with the Los Angeles Family and Neighborhood Survey.

Results. We found significant differences by citizenship and legal status in health insurance transitions. Undocumented immigrants were less likely to gain and more likely to lose insurance compared with native-born citizens. Legal residents were less likely to gain and were slightly more likely to lose insurance compared with native-born citizens. Naturalized citizens did not differ from native-born citizens.

Conclusions. Previous studies have not examined health insurance transitions by citizenship and legal status. Policies to increase coverage should consider the experiences of different immigrant groups.




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