Health insurance coverage of immigrants living in the United States: Differences by citizenship status and country of origin

Objectives. This study examined health insurance coverage among immigrants who are not US citizens and among individuals from the 16 countries with th e largest number of immigrants living in the United Stales. Methods. We analyzed data from the 1998 Current Population Survey, using lo gistic regression to standardize rates of employer-sponsored coverage by co untry of origin. Results. In 1997, 16.7 million immigrants were not US citizens. Among nonci tizens, 43% of children and 12% of elders lacked health insurance, compared with 14% of nonimmigrant children and 1% of nonimmigrant: elders. Approxim ately 50% of noncitizen full-time workers had employer-sponsored coverage, compared with 81% of nonimmigrant full-time workers. Immigrants from Guatem ala, Mexico, El Salvador, Haiti, Korea, and Vietnam were the most likely to be uninsured. Among immigrants who worked full-time, sociodemographic and employment characteristics accounted for most of the variation in employer health insurance. For Central American immigrants, legal status may play a role in high uninsurance rates. Conclusions. Immigrants who are not US citizens are much less likely to rec eive employer-sponsored health insurance or government coverage; 44% are un insured. Ongoing debates on health insurance reform and efforts to improve coverage will need to focus attention on this group.