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Do Children of Immigrants Make Differential Use of Public Health Insurance?

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  • Janet Currie

Abstract

Medicaid is one of the most costly welfare programs available to immigrants. This paper uses data from the 1989 to 1992 National Health Interview Survey to compare the effects of Medicaid eligibility on public and private health insurance coverage and on the utilization of medical services among children of natives and children of immigrants. Children of immigrants are more likely to be covered by Medicaid, but less likely to use health care. However, after conditioning on eligibility and other observable characteristics and instrumenting individual eligibility using an index of the generosity of state Medicaid regulations, I find that recent expansions of eligibility had negligible effects on Medicaid coverage among children of immigrants, although coverage rose among children of the native born. Among immigrants in border states, eligibility was also associated with declines in private health insurance coverage. Effects on utilization were quite different: becoming eligible increased the probability that a child had a doctor's visit more for immigrants than non-immigrants, but increased the hospitalization rate only among children of the native born. Hence, although recent Medicaid expansions shifted as much as one-quarter of the cost of providing infra-marginal services to children of immigrants from private to public insurers in border states, they drew many previously unserved children of immigrants into care.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 5388.

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Date of creation: Dec 1995
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Publication status: published as Issues in the Economics of Immigration, Borjas, George, ed., Chicago: University of Chicago Press, 2000.
Handle: RePEc:nbr:nberwo:5388

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  1. David M. Cutler & Jonathan Gruber, 1995. "Does Public Insurance Crowd Out Private Insurance?," NBER Working Papers 5082, National Bureau of Economic Research, Inc.
  2. Theresa J. Devine & James J. Heckman, 1996. "The Economics of Eligibility Rules for a Social Program: A Study of the Job Training Partnership Act (JTPA)--A Summary Report," Canadian Journal of Economics, Canadian Economics Association, vol. 29(s1), pages 99-104, April.
  3. Currie, J. & Thomas, D., 1995. "Medical Care for Children, Public Insurance, Private Insurance, and Racial Differences in Utilization," Papers 95-08, RAND - Reprint Series.
  4. Rebecca M. Blank & David Card, 1989. "Recent Trends in Insured and Uninsured Unemployment: Is There an Explanation?," NBER Working Papers 2871, National Bureau of Economic Research, Inc.
  5. Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc.
  6. George J. Borjas & Lynette Hilton, 1995. "Immigration and the Welfare State: Immigrant Participation in Means- Tested Entitlement Programs," NBER Working Papers 5372, National Bureau of Economic Research, Inc.
  7. Stephen J. Trejo, 1992. "Immigrant Welfare Recipiency: Recent Trends And Future Implications," Contemporary Economic Policy, Western Economic Association International, vol. 10(2), pages 44-53, 04.
  8. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-38, May.
  9. Rebecca M. Blank & Patricia Ruggles, 1993. "When Do Women Use AFDC & Food Stamps? The Dynamics of Eligibility vs. Participation," NBER Working Papers 4429, National Bureau of Economic Research, Inc.
  10. James J. Heckman & Thomas E. MaCurdy, 1985. "A Simultaneous Equations Linear Probability Model," Canadian Journal of Economics, Canadian Economics Association, vol. 18(1), pages 28-37, February.
  11. Gruber, J. & Currie, J., 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," Working papers 94-11, Massachusetts Institute of Technology (MIT), Department of Economics.
  12. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
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