Health insurance coverage and eligibility for California immigrants

California Health Care Critique

The Pew Hispanic Centre estimated in March 2005 that the illegal population in California had been 2.4 million people in 2004. This figure shows that there is huge potential in the impact which the immigrant population is likely to have on the health care businesses and systems in California. As a result there have been calls by many to reform these systems and protect the system (Passel, 2005).

The study by Ponce and colleagues (2005) was designed to inform the official policy design in California which was about to be undertaken at that time regarding health insurance in the State. The authors of the article were all employed by health service deliverers within California, which gave them appropriate requisite knowledge to undertake the study.

Body of the Article

Study Design

The purpose of the study was to inform the design of State efforts to provide health insurance to uninsured working immigrants. The study used a quantitative approach which was based on population-based survey data. The study was designed to model the employment-based coverage, the eligibility of immigrants for public insurance programs, and the affordability of current insurance options.

Literature Review

The literature review was thorough in presenting information relating to the purpose of the study. Several previous studies were highlighted relating to the insurance coverage of immigrant workers, which indicates that the study was well informed with regard to implications of previous studies. The sources which were used in the literature review were all very current which also indicates that the evidence behind assumptions used in the study was current and relevant. It was identified that there were factors which may impact particularly on new immigrants to the U.S., such as lower levels of English proficiency. The literature review identified that the current research made no distinction between new and older immigrants, which may affect the findings relating to effectiveness of insurance coverage.

Measurement

The study measured the likelihood of employment-based coverage, eligibility for public programs and affordability of premiums as the dependent variables. These were measured against citizenship status and years lived in the U.S. As the independent variables. These measures were suitable for the purpose of the study, as they would indicate any differences which were apparent in health insurance coverage between legal and illegal migrants through direct comparison of the dependent variable outcomes. The measures would also indicate if these were affected by the length of time the immigrant had been in the U.S., which was important as the main purpose of the study was to identify potential differences in coverage effectiveness between older and newer immigrants.

Analysis

The respondents were divided into 4 categories for data analysis, which were based upon the time spent in the U.S. This ensured that all analysis was directly relevant to the purpose of the study. The data was used to calculate relative risk ratios for the outcome measures. These were used to assess the risk probability of immigrants not obtaining employment-based health coverage. This allowed direct comparison between the different categories of immigrant, which was effective in highlighting any observed differences. The remainder of the data, which related to the coverage and affordability of premiums, was directly compared between the groups. While the percentages of the various categories of data were presented, it was difficult to easily deduce the outcomes of these comparisons.

Discussion and Conclusions

The study found that there was a difference in ability to obtain employment-based insurance dependent on the length of time the immigrant had lived in the U.S. The study concluded that the expansion of the county's current nonemployment-based insurance programs would result in coverage of more than 30% of the uninsured immigrant population. The study did not discuss whether there may be other alternatives which would encompass a greater number of immigrants into insurance programs.