Online Program

Cheaper by the immigrant: Would covering new immigrants from Mexico lower health costs and premiums?

Monday, November 4, 2013

Jacqueline Angel, PhD, Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, Austin, TX
Kimberly Wilson, MPIA, Division of Health Promotion and Behavioral Sciences, University of Texas Health Sciences Center School of Public Health, Austin, TX
H. Shelton Brown III, PhD, Division of Management, Policy and Community Health, University of Texas Health Sciences Center School of Public Health, Austin, TX
Introduction: The topic of immigration, its impact on health and health expenditures is of theoretical and practical interest given the expansions in insurance coverage accruing to legal immigrants under the Patient Protection and Affordable Care Act.

Methods: Utilizing data (n=648) from the 2007-2011 Mexican Migrant Project, we examine the association between aspects of migration and changes in self-rated health using two binary logistic regression models. Additionally, we estimate the costs of insurance coverage for this sample at first migration and at time of interview using the 2009 Medical Expenditures Panel Survey data and self-rated health as a health expense proxy.

Results: When age-at-interview is excluded, most of the covariates are statistically significant. When age is added, health prior to migration, age at interview, being from Central Mexico and use of health services in the U.S. remain significant and positively predictive of declines in health, and having spent more than 10 cumulative years in the U.S. has borderline significance (p=.052). Estimated coverage costs increase over time but remain lower than those of comparable U.S.-born individuals.

Conclusions: Our research demonstrates that positive selection does occur in immigration. Members of the sample were healthier upon arrival than Mexican Americans of their age residing in the U.S. However, their health declined at a faster rate, on average, than their U.S.-born counterparts so that, at time of interview, they report relatively worse health. Although we cannot say insurance is protective against health decline, our cost estimate data demonstrate that covering Mexican immigrants is inexpensive.

Learning Areas:

Biostatistics, economics
Public health or related public policy

Learning Objectives:
Compare the costs of providing insurance coverage to new migrants relative to the U.S. population. Identify the key differentiating characteristics of male Mexican migrants affecting health status.

Keyword(s): Latino Health, Health Insurance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student focused on disparities in health care access and chronic disease management in Mexican immigrant and Mexican-American populations. I have published one paper in this area with two others in-process, in addition to other projects in-process. My dissertation is going to be on a complementary topic.
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.