Abstract
Objectives To estimate the impacts of public health insurance coverage on health care utilization and unmet health care needs for children in immigrant families. Methods We use survey data from National Health Interview Survey (NHIS) (2001–2005) linked to data from Medical Expenditures Panel Survey (MEPS) (2003–2007) for children with siblings in families headed by at least one immigrant parent. We use logit models with family fixed effects. Results Compared to their siblings with public insurance, uninsured children in immigrant families have higher odds of having no usual source of care, having no health care visits in a 2 year period, having high Emergency Department reliance, and having unmet health care needs. We find no statistically significant difference in the odds of having annual well-child visits. Conclusions for practice Previous research may have underestimated the impact of public health insurance for children in immigrant families. Children in immigrant families would likely benefit considerably from expansions of public health insurance eligibility to cover all children, including children without citizenship. Immigrant families that include both insured and uninsured children may benefit from additional referral and outreach efforts from health care providers to ensure that uninsured children have the same access to health care as their publicly-insured siblings.
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Notes
We did not include data from more recent years because we did not want to combine data from the early phase of the implementation of the Affordable Care Act (ACA) with pre-ACA years.
In robustness checks, we added a variable for mother’s age at birth. Including this variable did not alter the pattern of results.
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Funding
Funding was provided by Robert Wood Johnson Foundation (Grant Nos ID0EISAE2390 and ID0EGZAE2391).
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Percheski, C., Bzostek, S. Public Health Insurance and Health Care Utilization for Children in Immigrant Families. Matern Child Health J 21, 2153–2160 (2017). https://doi.org/10.1007/s10995-017-2331-y
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DOI: https://doi.org/10.1007/s10995-017-2331-y