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Medicaid and Ethnic Networks

Author

Listed:
  • Gee Emily R.

    () (Boston University)

  • Giuntella G. Osea

    () (Boston University)

Abstract

Many low-income immigrants are uninsured yet eligible for public health insurance. In this paper, we examine whether language barriers and network effects can explain disparities in insurance Medicaid participation. Using the 2008 and 2009 American Community Survey, we show that linguistic networks facilitate Medicaid enrollment among non-English speaking adults. Our identification method follows Bertrand et al. (2000) and employs local variation in the density of immigrant populations and nationwide variation in Medicaid participation among ethnic groups. Given a hypothetical policy to increase Medicaid enrollment, for every 1 percentage point of direct increase, networks generate a multiplier effect that boosts participation by an additional 0.26 percentage points. Networks have greatest influence on individuals who are not proficient in English or who arrived in the United States more recently. Our results are robust to alternative specifications, including using an ex ante indicator of group-level participation. We also find that the availability of foreign-language Medicaid information online is associated with significantly higher participation.

Suggested Citation

  • Gee Emily R. & Giuntella G. Osea, 2011. "Medicaid and Ethnic Networks," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 11(1), pages 1-31, December.
  • Handle: RePEc:bpj:bejeap:v:11:y:2011:i:1:n:77
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    References listed on IDEAS

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    1. Per-Anders Edin & Peter Fredriksson & Olof Åslund, 2003. "Ethnic Enclaves and the Economic Success of Immigrants—Evidence from a Natural Experiment," The Quarterly Journal of Economics, Oxford University Press, vol. 118(1), pages 329-357.
    2. Olof Åslund & Peter Fredriksson, 2005. "Ethnic Enclaves and Welfare Cultures – Quasi-Experimental Evidence," CESifo Working Paper Series 1430, CESifo Group Munich.
    3. Anna Aizer, 2007. "Public Health Insurance, Program Take-Up, and Child Health," The Review of Economics and Statistics, MIT Press, vol. 89(3), pages 400-415, August.
    4. Borjas, George J, 1999. "Immigration and Welfare Magnets," Journal of Labor Economics, University of Chicago Press, vol. 17(4), pages 607-637, October.
    5. Marianne Bertrand & Erzo F. P. Luttmer & Sendhil Mullainathan, 2000. "Network Effects and Welfare Cultures," The Quarterly Journal of Economics, Oxford University Press, vol. 115(3), pages 1019-1055.
    6. Devillanova, Carlo, 2008. "Social networks, information and health care utilization: Evidence from undocumented immigrants in Milan," Journal of Health Economics, Elsevier, vol. 27(2), pages 265-286, March.
    7. Evans, William N & Oates, Wallace E & Schwab, Robert M, 1992. "Measuring Peer Group Effects: A Study of Teenage Behavior," Journal of Political Economy, University of Chicago Press, vol. 100(5), pages 966-991, October.
    8. Aizer, Anna & Currie, Janet, 2004. "Networks or neighborhoods? Correlations in the use of publicly-funded maternity care in California," Journal of Public Economics, Elsevier, vol. 88(12), pages 2573-2585, December.
    9. Borjas, George J, 1995. "Ethnicity, Neighborhoods, and Human-Capital Externalities," American Economic Review, American Economic Association, vol. 85(3), pages 365-390, June.
    10. Åslund, Olof & Fredriksson, Peter, 2005. "Ethnic enclaves and welfare cultures - quasi-experimental evidence," Working Paper Series 2005:8, IFAU - Institute for Evaluation of Labour Market and Education Policy.
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    Cited by:

    1. Julie Shi, 2016. "Income Responses to Health Insurance Subsidies: Evidence from Massachusetts," American Journal of Health Economics, MIT Press, vol. 2(1), pages 96-124, January.
    2. Halberstam, Yosh & Knight, Brian, 2016. "Homophily, group size, and the diffusion of political information in social networks: Evidence from Twitter," Journal of Public Economics, Elsevier, vol. 143(C), pages 73-88.
    3. Tara Watson, 2014. "Inside the Refrigerator: Immigration Enforcement and Chilling Effects in Medicaid Participation," American Economic Journal: Economic Policy, American Economic Association, vol. 6(3), pages 313-338, August.

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