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

In: Issues in the Economics of Immigration

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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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Suggested Citation

  • Janet Currie, 2000. "Do Children of Immigrants Make Differential Use of Public Health Insurance?," NBER Chapters, in: Issues in the Economics of Immigration, pages 271-308, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberch:6058
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    References listed on IDEAS

    as
    1. Shore-Sheppard Lara D., 2008. "Stemming the Tide? The Effect of Expanding Medicaid Eligibility On Health Insurance Coverage," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-35, July.
    2. Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, July.
    3. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    4. 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, April.
    5. Rebecca M. Blank & David E. Card, 1991. "Recent Trends in Insured and Uninsured Unemployment: Is There an Explanation?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1157-1189.
    6. 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.
    7. Janet Currie & Jonathan Gruber, 1994. "Saving Babies: The Efficacy and Cost of Recent Expansions of Medicaid Eligibility for Pregnant Women," NBER Working Papers 4644, National Bureau of Economic Research, Inc.
    8. George J. Borjas & Lynette Hilton, 1996. "Immigration and the Welfare State: Immigrant Participation in Means-Tested Entitlement Programs," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 575-604.
    9. Aaron S. Yelowitz, 1995. "The Medicaid Notch, Labor Supply, and Welfare Participation: Evidence from Eligibility Expansions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(4), pages 909-939.
    10. 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.
    11. 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.
    12. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
    13. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 391-430.
    14. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    15. Strauss, John & Thomas, Duncan, 1995. "Human resources: Empirical modeling of household and family decisions," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 34, pages 1883-2023, Elsevier.
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    17. repec:fth:prinin:361 is not listed on IDEAS
    18. Janet Currie & Duncan Thomas, 1995. "Medical Care for Children: Public Insurance, Private Insurance, and Racial Differences in Utilization," Journal of Human Resources, University of Wisconsin Press, vol. 30(1), pages 135-162.
    19. Lara Shore-Sheppard, 1996. "Stemming the Tide? The Effect of Expanding Medicaid Eligibility on Health Insurance Coverage," Working Papers 740, Princeton University, Department of Economics, Industrial Relations Section..
    20. Connell, F.A. & Day, R.W. & LoGerfo, J.P., 1981. "Hospitalization of medicaid children: Analysis of small area variations in admission rates," American Journal of Public Health, American Public Health Association, vol. 71(6), pages 606-613.
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    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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