One of the most troubling social trends in recent years has been the rapid increase in the number of people without health care insurance. Although there was a decline in the number of uninsured between 1998 and 1999, 42.6 million U.S.-residents are without health insurance coverage — almost 11.5 million more than in 1987. A larger uninsured population has broad-ranging effects on the nation’s entire health care system. Increases in the size of the uninsured population strain the resources of health care providers who struggle to provide services to the uninsured. Moreover, Americans with insurance have to pay higher premiums as health care providers pass along some of the costs of treating the uninsured to paying costumers. Taxpayers, too, are affected as federal, state, and local governments struggle to provide care to the growing ranks of the uninsured. While no definitive estimate exists, it is likely that between $15 and $30 billion a year, not including the cost for Medicaid, is spent providing services to the uninsured by governments at all levels. Although there is no single government program involved, providing care to the uninsured is a significant expense for society, with much of the cost borne by taxpayers and those who do have health insurance.
Lack of Health Insurance Common Among Mexican Immigrants. More than half (52.6 percent) of Mexican-born persons living in the United States have no health insurance. For natives the corresponding figure is 13.5 percent.25 While not as prevalent as among Mexicans, lack of insurance is also common among immigrants in general. In 1999, 33.4 percent of the foreign-born were uninsured. Not surprisingly, lack of insurance is also a severe problem among the U.S.-born children (under age 18) of Mexican immigrants, with almost one-third lacking coverage.26 The children of Mexican immigrants are more likely to have insurance than their parents because a large percentage of those born in the United States are covered by Medicaid.
Figure 17 shows the percentage of Mexican immigrants and their American-born children without health insurance. The figure shows that 45.9 percent of Mexican immigrants and their U.S.-born children do not have health insurance, compared to 13.1 percent of natives and their children. The figure also shows that 18.5 percent of Mexicans and their children are covered by Medicaid compared to 9.7 percent of natives. The fact that Mexican immigrants and their children are more likely than natives to use Medicaid means that by itself, lack of Medicaid use does not explain why so many Mexican immigrants and their children do not have health insurance. The results in Figure 17 show that 64.4 percent of Mexican immigrants and their children either have no health coverage or have it provided to them at government expense.
Overall, Mexican immigration has contributed significantly to the size of the nation’s uninsured population. Although they comprise 4.2 percent of the nation’s entire population, the 5.3 million Mexican immigrants without health coverage and their U.S.-born children under age 18 account for 12.5 percent of the uninsured. Moreover, immigration from Mexico accounts for a significant share of the increase in the nation’s uninsured population over the last decade. Mexican immigrants who arrived between 1988 and 1999 and the children born to these immigrants after they settled in the United States accounted for 28.7 percent or 3.3 million of the total growth in the size of the uninsured population after 1987. Thus Mexican immigration has played a significant role in exacerbating the nation’s health insurance coverage crisis.
Lack of Health Insurance Remains a Problem Even for Long-Time Mexican Immigrants. Even after they have lived in the country for many years, lack of health insurance remains a severe problem among Mexican immigrants. Figure 18 shows health insurance coverage among Mexicans based on years of residence in the United States. The figure shows that 62.9 percent of immigrants from Mexico who have lived in the United States for 10 years or less are uninsured. For those who have lived in the United States between 11 and 20 years, 47.5 percent are uninsured; among those who came to the country 21 to 30 years ago, 38.8 percent were without health insurance; and for those who arrived more than 30 years ago, 28 percent were still uninsured in 2000. Thus, while Mexican immigrants clearly make progress the longer they live in the United States, those who have lived in the country for many years are still more than twice as likely as natives to be without health insurance.
Insurance Coverage Among Legal and Illegal Mexican Immigrants. Among the nearly three million illegal aliens from Mexico in the CPS, we estimated that more than two-thirds, 68.4 percent, do not have health insurance coverage. However, lack of insurance is common even among the estimated 4.9 million legal Mexican immigrants living in the United States. We estimated that 41.4 percent of legal Mexican immigrants do not have insurance, making them more than three times as likely as natives to be uninsured. Clearly, lack of health insurance coverage among the Mexican-born population is not simply a matter of legal status.
As is the case with poverty, income, and welfare, the low skill level of Mexican immigrants has a direct bearing on why so many lack insurance. Because of the limited value of their labor in an economy that increasingly demands educated workers, many immigrants hold jobs that do not offer health insurance, and their low incomes make it very difficult for them to purchase insurance on their own.
25 This 13.5 percent figure includes the American-born children (under18) of immigrants. The numbers in Figure 17 do not include these children.
26 These figures include the American-born children of Mexican immigrants.