Health Insurance Coverage: Logical Versus Survey Identification of the Foreign-Born

Area of Science:

• Health Services Research
• Immigration Policy
• Social Science Research Methods

Background:

• Accurate estimation of public benefit use among lawful permanent residents (LPRs) is hindered by data limitations.
• Nationally representative data often fail to disaggregate the foreign-born population by specific legal statuses.

Purpose of the Study:

• To compare two methods for inferring legal status and estimating health insurance coverage among LPRs.
• To assess the potential overestimation of public benefit reliance using a logical inference method versus a survey-based approach.

Main Methods:

• Utilized the 2008 Survey of Income and Program Participation (SIPP) data.
• Employed logistic regression to compare health insurance coverage estimates.
• Compared a logical approach with a survey-based approach for inferring LPR legal status.

Main Results:

• The logical approach yielded a higher predicted probability of any insurance for LPRs (adjPP=0.70) than the survey approach (adjPP=0.57).
• The logical approach indicated a higher likelihood of public health insurance (adjPP=0.26) compared to the survey approach (adjPP=0.09).

Conclusions:

• The logical approach may overestimate lawful immigrants' reliance on public benefits.
• Findings have significant implications for understanding the impact of recent changes to the public charge rule.