Volume 47 - Article 16 | Pages 453–488

Legal status and health disparities: An examination of health insurance coverage among the foreign-born

By Christal Hamilton, Claire Altman, James Bachmeier, Cody Spence

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Date received:09 Aug 2021
Date published:20 Sep 2022
Word count:5755
Keywords:health insurance, immigration, imputation, legal status


Objective: This paper employs a statistical matching procedure to impute the legal status of foreign-born adults in US Census surveys in order to estimate migration status disparities in health insurance coverage.

Methods: Using data from the Survey of Income and Program Participation, we impute the legal/citizenship (migration) status of immigrants in the National Health Interview Survey.

Results: Results from the pooled data document disparities in health insurance coverage among four citizen/legal status groups: naturalized citizens, lawful permanent residents, legal nonimmigrants, and unauthorized immigrants. Naturalized citizens had the highest rate of health insurance coverage, followed by legal immigrants, legal nonimmigrants, and unauthorized immigrants.

Contribution: The paper presents revised pre–Affordable Care Act (ACA) estimates of health insurance coverage among the foreign-born that are crucial for evaluating the impact of the ACA on reducing or exacerbating disparities in health coverage among migration status groups.

Author's Affiliation

Christal Hamilton - Columbia University, United States of America [Email]
Claire Altman - University of Missouri, United States of America [Email]
James Bachmeier - Temple University, United States of America [Email]
Cody Spence - Temple University, United States of America [Email]

Other articles by the same author/authors in Demographic Research

» Citizenship Reporting in the American Community Survey
Volume 29 - Article 1

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