Determinants of private health insurance coverage among Mexican American men 2010–2013

Abstract

Background: Private health insurance (PHI) represents the largest source of insurance for Americans. Hispanic Americans have one of the lowest rates of PHI coverage. The largest group in the US Hispanic population are Mexican Americans; they account for about two in every three Hispanics. One in every three Mexican Americans aged 64 years and under did not have health insurance coverage. Mexican Americans have the most unfavorable health insurance coverage of any population group in the nation.

Objectives: The objective is to determine the factors associated with the gap in PHI coverage between Mexican American and non-Hispanic American men.

Methods: This study used the National Health Interview Surveys (2010–2013) as the sample. A non-linear Oaxaca-Blinder decomposition was run, estimating the explained and unexplained gap in PHI coverage between the groups. Several robustness tests of the model were also included.

Results: This study estimates that 44.4% of employed Mexican American men are covered by PHI compared to 79.5% of non-Hispanic American men. Nearly 60% of employed Mexican American men were found to be foreign born, 35% have an educational attainment less than a high school degree, and 40% are likely to have language barriers. Decomposition results show that income, low educational attainment, being foreign-born, and language barriers diminished the probability of private health insurance coverage for Mexican Americans, and that 10% of the gap is unexplained.

Conclusions: Most of the difference in the PHI rate between Mexican American men and non-Hispanic men is explained by observable differences in group characteristics: education, language, and immigration status. About 10% of the difference can be attributed to discrimination under the traditional interpretation of an Oaxaca-Blinder decomposition. The PHI rate gap is large and persistent for Mexican American men.

Keywords:

• Mexican American men
• private health insurance
• Oaxaca decomposition
• health disparities

JEL Classification Codes:

• I13
• I14
• J15

This article is related to:

The whole is greater than the sum of its parts: the importance of integrated, universal, and equitable healthcare coverage

Notes

Transparency

Declaration of financial/other relationships

There are no financial or other conflicts of interests to report for this submission. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

We thank the UNM Department of Economics, the Combined BA/MD program at UNM, and the Robert Wood Johnson Foundation Center for Health Policy at UNM.

Previous presentations

Earlier versions of this paper were presented at the American Society of Health Economics 2016, Philadelphia, PA, and the Allied Social Science Associations Meeting, American Society of Hispanic Economists Panel Session, 2016, San Francisco, CA.

Data availability statement

The data that support the findings of this study are openly available through IPUMS Health Surveys at https://nhis.ipums.org/nhis/. IPUMS Health Surveys harmonizes data from the National Health Interview Survey (NHIS) and allows users to create custom NHIS data extracts for analysis.

Notes

1 The results are fundamentally the same with and without year dummies.

2 The smaller sample (see Tables 2 and 3) has the same inclusion/exclusion criteria discussed in Section 1, and additionally the individual needed to be selected for the supplemental survey which included questions on industry and occupation. The smaller sample characteristics are not reported, but are very similar to the large sample, and are available upon request.

3 There are 21 industry categories and 23 occupation categories among the employed men; the data is not able to identify workers who are employed by the same firm.

Additional information

Funding

There is no funding to report for this submission.