English Skills and the Health Insurance Coverage of Immigrants

Many immigrants lack both English skills and health insurance coverage. Understanding the effect of English skills on health insurance is difficult because English skills are correlated with many unobservable characteristics that are also related to health insurance. In this paper, I exploit the fact that young children can learn a new language much more easily than older children to examine how English skills affect health insurance coverage for immigrants and their children. I find that English skills greatly improve immigrants' access to employer-sponsored health insurance. While Medicaid covers a majority of children who do not have employer-sponsored health insurance because of their immigrant parents' poor English skills, immigrants with poor English skills are much more likely to be uninsured. I test for heterogeneous responses to Medicaid expansions based on English ability and find evidence that the effect of satisfying Medicaid's income requirements on Medicaid coverage is smallest for immigrants with the worst English skills, which suggests that the different effects for parents and their children may not be entirely because of different Medicaid income thresholds for adults and children.