Private Health Insurance and Employer-Provided Health Insurance Coverage among Hispanic Americans 2010-2015

Most Americans obtain private health insurance for themselves and their families through the workplace. Using a national sample of adults age 18-64 from the 2010-2014 National Health Interview Survey (NHIS) and the Current Population Survey (CPS), we estimate that only 40 percent of the Hispanics in the labor force are covered by private health insurance coverage as compared to 72 percent of other non-Hispanics. What accounts for the difference in insurance coverage between Hispanic and non-Hispanic workers? Is the difference explained by age, education, nativity, language, or other human capital characteristics which would affect access to private health insurance? For example, nearly 60% of Mexican American men in the labor force are foreign born, 35% have an educational attainment less than a high school degree, and 40% are likely to have language barriers. Is the insurance disparity caused by these human capital characteristics and is the disparity compounded by discrimination encountered by Mexican American men in the workplace and their access to private health insurance coverage? What if Mexican American men had similar characteristics as those of other workers, would their predicted private health insurance coverage be as favorable as other workers?

To study the determinants and factors influencing the rate of private health insurance and employer-provided health insurance among Hispanics, we use the 2010-2014 NHIS and the CPS 2010-2015. The CPS includes information on firm size (which is missing from the NHIS) and the CPS data for 2015 is available allowing us to consider a longer period after the implementation of the ACA, while the NHIS has good information on self-rated health and other health related habits that may influence coverage status. Logistic equations are estimated separately for the determinants of insurance coverage among Hispanics and non-Hispanics. Also, we perform sub-group analysis on men and women, Mexican Americans and other Hispanics, and across industries and geographic regions. A decomposition analysis is used to explain the disparity in insurance coverage. We consistently show that age, low educational attainment, being foreign-born, and language barriers diminish the probability of insurance coverage for Hispanics. About 90 percent of the gap can be explained. Nevertheless, a disparity in health insurance coverage for Hispanics remains after accounting for these characteristics and nativity and language differences could be indicative of systematic discrimination. These findings are persistent after the Affordable Care Act. The ACA seems to have little impact on Hispanic workers especially immigrant workers and their families in the areas of private or employer-provided health insurance. In fact, our results indicate public programs may be providing coverage to a greater proportion of these populations in 2014 and 2015.