MEDICAID ENROLLMENT AND HEALTH-SERVICES ACCESS BY LATINO CHILDREN IN INNER-CITY LOS-ANGELES

Objectives.-To understand the role of parental immigration status on M edicaid enrollment and access to health services for young Latino chil dren. Design.-A cross-sectional household survey of the parents of inn er-city Latino children. Setting.-South Central and East Los Angeles, Calif, 1992. Population.-Children 12 to 36 months old and their parent s from 817 Latino families, Main Outcome Variables.-Continuous Medicai d enrollment, continuity of care, deferral of care, and number of visi ts. Methods.-Univariate analysis, logistic and linear regression by de mographic and socioeconomic characteristics, residency status, and lan guage use, Results.-Children were primarily born in the United States (96%), but most parents were not citizens (80%). Only 40.0% of eligibl e children had continuous Medicaid coverage since birth, 18.6% had nev er been insured, and 20.7% had received episodic Medicaid coverage, Co ntinuous Medicaid coverage was negatively associated with either the c aregiver (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.19-0. 56) or their partner (OR=0.33, 95% Cl=0.20-0,55) working, Residency st atus, language preference, and length of US residency were not associa ted with continuous Medicaid enrollment. Insurance coverage was associ ated with more physician visits, greater continuity of care, and fewer deferrals of care. Conclusion.-While most (84%) young Latino children in inner-city Los Angeles were eligible for Medicaid, a substantial p roportion (39.3%) have episodic or no coverage. Insurance status and p rovider type were more consistently associated with access rather than residency and language preference. In the aftermath of California's P roposition 187 and federal welfare reform, insurance status and access are likely to worsen for these young children unless the wave of anti -immigration sentiments is held in check.