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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.

Suggested Citation

  • Janet Currie, 1995. "Do Children of Immigrants Make Differential Use of Public Health Insurance?," NBER Working Papers 5388, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:5388
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    References listed on IDEAS

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    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.
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    Cited by:

    1. Jonathan Gruber & Aaron Yelowitz, 1999. "Public Health Insurance and Private Savings," Journal of Political Economy, University of Chicago Press, vol. 107(6), pages 1249-1274, December.
    2. A. S. Yelowitz, "undated". "Public Policy and Health Care Choices of the Elderly: Evidence from the Medicare Buy-In Program," Institute for Research on Poverty Discussion Papers 1136-97, University of Wisconsin Institute for Research on Poverty.
    3. Jonathan Gruber, 2003. "Medicaid," NBER Chapters,in: Means-Tested Transfer Programs in the United States, pages 15-78 National Bureau of Economic Research, Inc.
    4. Sweetman, A. & van Ours, J.C., 2014. "Immigration : What About the Children and Grandchildren?," Discussion Paper 2014-009, Tilburg University, Center for Economic Research.
    5. Yelowitz, Aaron S., 2000. "Public policy and health insurance choices of the elderly: evidence from the medicare buy-in program," Journal of Public Economics, Elsevier, vol. 78(3), pages 301-324, November.
    6. Kristin F. Butcher & Anne Morrison Piehl, 1998. "Recent Immigrants: Unexpected Implications for Crime and Incarceration," ILR Review, Cornell University, ILR School, vol. 51(4), pages 654-679, July.
    7. Currie, Janet & Fahr, John, 2005. "Medicaid managed care: effects on children's Medicaid coverage and utilization," Journal of Public Economics, Elsevier, vol. 89(1), pages 85-108, January.
    8. Jonathan Gruber, 1997. "Policy Watch: Medicaid and Uninsured Women and Children," Journal of Economic Perspectives, American Economic Association, vol. 11(4), pages 199-208, Fall.
    9. Momi Dahan & Udi Nisan, 2010. "The effect of benefits level on take-up rates: evidence from a natural experiment," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 17(2), pages 151-173, April.
    10. Jonathan Gruber, 1997. "Health Insurance for Poor Women and Children in the U.S.: Lessons from the Past Decade," NBER Chapters,in: Tax Policy and the Economy, Volume 11, pages 169-211 National Bureau of Economic Research, Inc.
    11. 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.
    12. Henrik Jacobsen Kleven & Wojciech Kopczuk, 2011. "Transfer Program Complexity and the Take-Up of Social Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 3(1), pages 54-90, February.
    13. Borjas, George J., 2003. "Welfare reform, labor supply, and health insurance in the immigrant population," Journal of Health Economics, Elsevier, vol. 22(6), pages 933-958, November.
    14. Janet Currie & Jonathan Gruber, 1997. "The Technology of Birth: Health Insurance, Medical Interventions, and Infant Health," NBER Working Papers 5985, National Bureau of Economic Research, Inc.
    15. Julie Janssens & Natascha Van Mechelen, 2017. "Who is to Blame? An Overview of the Factors Contributing to the Non-Take-Up of Social Rights," Working Papers 1708, Herman Deleeck Centre for Social Policy, University of Antwerp.
    16. Blanco Mariana & Vargas Juan F., 2014. "Can SMS Technology Improve Low Take-up of Social Benefits?," Peace Economics, Peace Science, and Public Policy, De Gruyter, vol. 20(1), pages 61-81, January.
    17. Pylypchuk, Yuriy & Selden, Thomas M., 2008. "A discrete choice decomposition analysis of racial and ethnic differences in children's health insurance coverage," Journal of Health Economics, Elsevier, vol. 27(4), pages 1109-1128, July.
    18. Buchmueller Thomas C & Lo Sasso Anthony T & Wong Kathleen N, 2008. "How Did SCHIP Affect the Insurance Coverage of Immigrant Children?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-25, January.
    19. Luojia Hu, 1999. "Use of Means-Tested Transfer Programs by Immigrants, Their Children, and Their Children's Children," JCPR Working Papers 71, Northwestern University/University of Chicago Joint Center for Poverty Research.
    20. Melonie P. Heron & Leo S. Morales, 2002. "Latino Health, Nativity and Socioeconomic Status," Working Papers 02-06, RAND Corporation.
    21. Patricia Reagan & Randall Olsen, 2000. "You can go home again: Evidence from longitudinal data," Demography, Springer;Population Association of America (PAA), vol. 37(3), pages 339-350, August.
    22. Worswick, Christopher, 2001. "School Performance of the Children of Immigrants in Canada, 1994-98," Analytical Studies Branch Research Paper Series 2001178e, Statistics Canada, Analytical Studies Branch.
    23. Bronchetti, Erin Todd, 2014. "Public insurance expansions and the health of immigrant and native children," Journal of Public Economics, Elsevier, vol. 120(C), pages 205-219.
    24. Carol Rapaport & Reagan Murray, 2000. "Health insurance trends point to an increase in uninsured children in New York and New Jersey," Current Issues in Economics and Finance, Federal Reserve Bank of New York, vol. 6(Feb).

    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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