The Enigma of Higher Income Immigrants With Lower Rates of Health Insurance Coverage in the United States

This research compares rates of health insurance coverage among middle-class non-elderly immigrants to native-born American adults using data from the March 1996–2000 Supplements to the Current Population Survey. Probit regressions reveal that immigrants were three times as likely to be uninsured at income levels exceeding$50,000, controlling for economic, demographic and immigrant-related characteristics. Work-related characteristics, income, martial status and nativity considerably influenced health insurance status for all adults, but work-related factors had the strongest effect on immigrants' rates of coverage. Why, ceteris paribus, immigrants have lower coverage rates is unclear. Many low-income and recent immigrants face barriers to access due to legal status or job sector. But lower rates of health insurance coverage which persist among long-time residents at higher income levels cannot be explained by such barriers, a finding highly relevant for policy makers. Encouraging uninsured immigrants to opt into health plans voluntarily will remain a challenge.