UCLA Study: Even With Coverage, Undocumented Use Fewer Services

UCLA researchers yesterday released a study that found the undocumented population in California uses far fewer health care services than U.S. citizens — even among those undocumented individuals who have insurance coverage.

According to the UCLA Center for Health Policy Research study:

  • Undocumented immigrants in California see the doctor and visit emergency rooms significantly less often than U.S. citizens;
  • Undocumented immigrants seek fewer preventive health services; and
  • One in 10 undocumented adults visits an emergency department every year, compared with roughly one in five U.S.-born adults — putting ED use by the undocumented in California at roughly half the rate of U.S.-born residents.

The low level of health care utilization was not surprising, given the barriers to care faced by undocumented immigrants, said Nadereh Pourat, the study’s lead author and director of research at the UCLA Center for Health Policy Research. Undocumented immigrants predominantly are low-income individuals, often with language barriers, who fear revealing their immigration status, Pourat pointed out.

However, what was surprising is that those low utilization rates hold true even for the undocumented immigrants who have health care coverage, Pourat said.

“If you have insurance, you use more care, that’s a given. Insurance removes financial barriers to accessing services,” Pourat said.

“But when you compare the insured who are undocumented, you still see an underutilization,” she said. “The implications are, you wouldn’t expect to spend as much or more by covering the undocumented.”

Partly that’s because covered and undocumented individuals tend to be younger, she said.

The new research has many implications for SB 1005 by Sen. Ricardo Lara (D-Bell Gardens), a bill designed to cover the residually uninsured in California.

“What we see is that coverage will help, but it won’t send everyone knocking at the door,” Pourat said. “The cost of insuring the undocumented likely would be lower.”

Lara’s bill is waiting for a CalSIM cost estimate. Pourat said the new study’s data should help inform that projection.

“Anticipated utilization should have an impact on the estimate of premiums,” she said. “It will be very interesting to see what happens to the Lara bill, and whether the public can understand and internalize what’s actually happening with [health care for] the undocumented.”

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