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

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.