Immigrants Accounted for 26% of Uninsured U.S. Residents in 2003, Study Finds
Immigrants accounted for 26% -- or 11.6 million people -- of the nation's uninsured in 2003, a 70% increase from 1994, according to a study released Monday by the Employee Benefit Research Institute, the Wall Street Journal reports (Goldfarb, Wall Street Journal, 6/14). The study, led by EBRI Director of Health Research Paul Fronstin and based on census data from between 1994 and 2003, found:
- Noncitizens were more than twice as likely to be uninsured as naturalized citizens;
- Immigrants who arrived in the United States after 2000 were twice as likely to be uninsured as those who arrived before 1970;
- 60% of uninsured immigrants lived in four states -- California (27%), Texas (15%), New York (10%) and Florida (9%) (Lipman, Atlanta Journal-Constitution, 6/14); and
- Immigrants represented 86% of the growth in the number of uninsured between 1998 and 2003.
Fronstin said one reason for the increase of uninsured might have been the 1996 welfare-reform law, which imposed a five-year restriction on new immigrants for enrollment in public benefit programs such as Medicaid (Wall Street Journal, 6/14). Fronstin also said that increasing health insurance premiums, age, occupation and culture contribute to the number of uninsured immigrants (Atlanta Journal-Constitution, 6/14).
Fronstin said, "They are uninsured because health costs are rising. They are uninsured because they are disproportionately employed by small businesses. They are uninsured because they have service and agricultural jobs that are less likely to come with benefits" (Los Angeles Times, 6/14). He said, "To the degree that immigration continues to increase, it is likely that the uninsured will also continue to increase" (CQ HealthBeat, 6/13). Fronstin said the results of the study will "put added pressure on policy makers to address the issues of the uninsured" (Gibson, South Florida Sun-Sentinel, 6/14).
Jennifer Ng'andu, health policy analyst for the National Council of La Raza, said the report shows the need for health care reform that makes it easier for employers to offer coverage, as well as the need to increase access to government-sponsored health insurance programs. She said, "When immigrants are offered health insurance coverage, ... even though it is expensive, they will pay for it because they realize health coverage is essential to access the health care system" (Atlanta Journal-Constitution, 6/14).
Rep. Tom Tancredo (R-Colo.) said, "These numbers are dramatic and are helpful in the debate we're having here. We've already told our colleagues a hundred times in a hundred ways the uninsured noncitizens in this country are creating an enormous burden on our health care system" (South Florida Sun-Sentinel, 6/14).
Steven Camarota, research director at the Center for Immigration Studies, said, "What this tells us is there is a very high cost to cheap labor" (Los Angeles Times, 6/14). The study is available online. Note: You must have Adobe Acrobat Reader to view the study.
About 16 million U.S. adults are underinsured and often go without needed medical services, medications and follow-up care, primarily because of the associated costs, according to a study published Monday on the Health Affairs Web site, the Chicago Tribune reports. The study defines the underinsured as those whose medical expenses account for at least 10% of their income, or, among low-income U.S. residents, 5% of their income.
Almost three out of four underinsured U.S. adults are considered low-income, the study finds. People with high deductibles and coverage limitations also can be considered underinsured, the Tribune reports. According to the study, 38% of those who are underinsured often choose not to fill prescriptions; 32% decide not to see a doctor even when they have a medical problem; 30% avoid medical tests, treatment or follow-up care; and 18% decline care from specialists, primarily because the services are too costly.
The underinsured also have trouble paying their medical bills compared with people who have comprehensive insurance plans. Forty-six percent of people with more limited coverage reported being contacted by a collection agency regarding unpaid medical bills, and 35% said they have had to change their lifestyle to cover medical expenses, the study says. People who have no health coverage are reported to show similar behavior to the underinsured, the Tribune reports.
Lead author Cathy Schoen, vice president of the Commonwealth Fund, said that in the near future, "it could become harder to differentiate consumers who are underinsured from those who are uninsured."
If the trend continues, as expected, "the number of the underinsured [will] grow enormously in the years ahead," and people who are sick will be disproportionately affected, Ron Pollack, executive director of Families USA, said. Pollack added that low-cost, high-deductible plans such as health savings accounts could contribute to the problem if consumers do not have the financial means to pay for services in advance.
Susan Pisano, a spokesperson for America's Health Insurance Plans, said, "Choice of products is a good thing," adding, "These options won't work for everyone, but they do address real needs in the market" (Graham, Chicago Tribune, 6/14). An abstract of this study is available online.