261166 Immigration status and the uninsured in California: The impact of the Great Recession

Tuesday, October 30, 2012 : 12:45 PM - 1:00 PM

Shana A. Lavarreda, PhD, MPP , Center for Health Policy Research, UCLA, Los Angeles, CA
Sophie Snyder , Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, CA
Background. In the Fall of 2008, California entered a prolonged recession that resulted in a sharp increase in the uninsured population from 6.4 million in 2007 to 7.1 million in 2009. Although non-citizens without green cards comprised only 6.1% of California's nonelderly population in 2009, there is a misconception that they drive the increase in the uninsured. We will examine the uninsured population through the lens of citizenship status, and discuss the implications of our findings in relation to the implementation of the Affordable Care Act of 2010 (ACA).

Objectives. To examine the increase of the U.S.-born population as a percentage of the uninsured in California from 2007 to 2009, determining if this increase is still significant after controlling for other factors, including household income and job loss.

Methods. Bivariate and multivariate analysis of the 2007 and 2009 California Health Interview Surveys.

Results. Our initial results indicate that the largest and also fastest-growing group within the uninsured is U.S.-born citizens, due to both the loss of health insurance among this population and the overall decrease of non-citizens without a green card in California.

Conclusions and Policy Implications. The ACA will benefit non-Latinos disproportionately due to the exclusion of non-citizens without a green card from any of the expansions. The existing disparities in health insurance coverage and resulting access to the health care system will be exacerbated as the ACA is implemented, with the possibility that more than one million Californian residents (including non-citizen children) will be left out.

Learning Areas:
Communication and informatics
Diversity and culture
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss the impact of the Great Recession on the uninsured population in California, in terms of citizenship status. Describe how the ACA citizenship provisions exclude undocumented immigrants.

Keywords: Immigrants, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a research scientist at the UCLA Center for Health Policy Research. As the Center's director of Health Insurance Studies, I work with numerous projects, including the State of Health Insurance in California (SHIC) project and the California Health Benefits Review Program (CHBRP). The SHIC project acts as a statewide and national resource for health insurance information, creating and disseminating reports, fact sheets, policy briefs and on-demand data estimates.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.