The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation
Article first published online: 24 JUN 2014
© Health Research and Educational Trust
Health Services Research
Volume 49, Issue 6, pages 1900–1924, December 2014
How to Cite
Vargas Bustamante, A. and Chen, J. (2014), The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation. Health Services Research, 49: 1900–1924. doi: 10.1111/1475-6773.12193
- Issue published online: 19 NOV 2014
- Article first published online: 24 JUN 2014
- Eunice Kennedy Shiver National Center for Child Health and Human Development. Grant Number: R24 HD041041
- total health care costs;
- two-part model;
We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence.
Uninsured U.S. citizens and noncitizens from the 2005–2006 and 2008–2009 Medical Expenditure Panel Survey.
The probability of reporting any health spending and the natural logarithm of health spending are our main dependent variables. We compare health spending across population categories before/during the GR. Subsequently, we implement two-part regression analyses of total and specific health-spending measures. We predict average health spending before/during the GR with a smearing estimation.
The probability of reporting any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported higher spending during the GR (27 percent). Average reductions in total spending were driven by the decline in the share of the population reporting any spending among citizens and noncitizens.
Our study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation.