"Mutual Responsibility": A Study of Uninsured Immigrants' Perspectives on Health Insurance in New York City
This report describes the results of a study conducted by the New York Immigration Coalition, with grant support from the Fund, that explored the barriers to maintaining health insurance faced by immigrants in New York. As has been documented elsewhere, non-citizens are substantially less likely than citizens to have private coverage and have relatively low public program participation rates; as a result, one-third of non-citizens are uninsured, compared with 12 percent of citizens.
Participants in the study included immigrants who were eligible for public health insurance coverage in New York as well as immigrants who were ineligible for public coverage on the basis of income or immigration status. The report analyzes the factors driving their choices and the policy designs that could increase enrollment in health insurance among this population.
The study found that lack of health insurance coverage caused immigrants to delay and avoid needed care, and that there was overwhelming interest in health insurance and a preference for coverage that is affordably priced, not necessarily free. The report also describes the administrative, linguistic, and cultural barriers many immigrants face when enrolling in public coverage.
These findings are especially important in the context of the current health care reform debate. While proposed health reform bills put forth limited new coverage options for non-citizens, they may be equally likely to erect formidable new barriers to coverage. A greater understanding of immigrants' reluctance to enroll in public coverage, willingness to pay, and preferences for coverage and care is an important component of these discussions.