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Private Insurance for Undocumented Latino Immigrants: A Qualitative Study of a Marketplace-Like Model
Christine C Welles1, Katherine Rizzolo2, Carol Gorman3
1Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA. christywelles@gmail.com.
Background:
Undocumented immigrants without health insurance often delay or forgo essential care, potentially leading to more severe disease presentations and higher healthcare costs. Marketplace-like private health insurance programs may improve the well-being of undocumented immigrants.
Objective:
To understand the experiences of participants enrolled in a state-sponsored private health insurance program in the state of Colorado.
Design:
From November 2023 to April 2024, three bilingual members of our study team conducted semi-structured interviews and collected demographic information. Interviews were audio recorded, translated, and transcribed. The interviews were coded inductively using thematic analysis.
Participants:
Fifty-five undocumented immigrants who enrolled in OmniSalud, a private health insurance program, during 2023 and/or 2024 were interviewed, including (1) individuals who had OmniSalud in 2023 and re-enrolled for 2024; (2) individuals who had OmniSalud in 2023 but were unable to re-enroll for 2024 due to spots running out in less than 48 h; and (3) individuals who newly enrolled for OmniSalud in 2024.
Approach:
Themes and subthemes from semi-structured interviews.
Key Results:
Fifty-five individuals participated (58% women (n = 32) and 42% men (n = 23); mean [SD] age, 47 [10] years). Five themes were identified: (1) shift to proactive care rather than reactive treatment for advanced disease, (2) breaking down financial barriers to care, (3) relief from the distress of not receiving the standard of care, (4) experiences enrolling in insurance and navigating the healthcare system, and (5) gratitude, loss, and desire to expand the private health insurance program.
Conclusions:
After receiving state-sponsored private health insurance, participants no longer avoided care due to cost. They sought care more proactively, with greater use of preventive care, better control of chronic disease, decreased anxiety, and less need for emergency care. Adoption of similar healthcare policies in other states should be considered to improve the health and well-being of undocumented immigrant populations.
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