Medicare Reduces Insurance Disparities Between Immigrant and Nonimmigrant Adults

The immigrant population in the United States continues to increase and public insurance programs, like Medicare, play a significant role in reducing coverage disparities for immigrants vs nonimmigrants, according to a recent JAMA Network Open study.

“We believe these findings have timely ramifications for physicians and policymakers in the midst of an evolving health care system undergoing reform and increasingly demanding value,” said the researchers.

The cohort study of 9691 US adults showed that recent immigrants were found to be 15% less likely than nonimmigrants to have health insurance at baseline but over a 24-year period, the disparity was eliminated due to the uptake of public insurance.

Participants were categorized as either a nonimmigrant (born in the United States), early immigrants(immigrated to the United States before the age of 18), and recent immigrants (immigrated to the United States from the age of 18 years and older).

Researchers examined immigrants and nonimmigrants from 1992 to 2016, measuring insurance status biennially. The disparity at baseline was associated with lower rates of private insurance plans. Insurance coverage increased from 68%, 83%, and 86% of recent immigrant, early immigrant, and nonimmigrant older adults, respectively, in 1992 to 97%, 100%, and 99% in 2016.

“We did not find differences in rates of insurance coverage between early immigrants and nonimmigrants, which we hypothesize is associated with an increased awareness and knowledge about the US health care and insurance systems,” said the researchers.

With the number of US adults reaching Medicare eligibility age rising, monitoring health insurance coverage among older US immigrants is a nationwide priority, noted the researchers in the study.

“Given that immigrants are a sizable proportion of the overall population, the American College of Physicians has led several calls to action arguing that access to care for immigrants is a national public health issue,” continued the study’s authors. —Edan Stanley