If immigrant parents face higher transactions costs of enrolling in Medicaid, and different opportunities in the market for private health insurance, then their responses to becoming eligible for Medicaid are likely to differ from those of native-born parents. This prediction is tested using data about health insurance coverage and the utilization of medical care from the U.S. National Health Interview Survey. The results suggest that focusing on coverage alone will produce misleading assessments of the costs and benefits of expanding Medicaid eligibility for immigrants since among immigrants, eligibility increases utilization of basic services without affecting coverage. Second, the marginal cost of the additional medical services consumed by eligible immigrant children is small. However, the infra-marginal costs of expanding Medicald eligibility to immigrants may be quite large, because as much as a quarter of the cost of providing infra-marginal services is shifted from private to public insurers.
This report is part of the RAND Corporation draft series. The unrestricted draft was a product of the RAND Corporation from 1993 to 2003 that represented preliminary or prepublication versions of other more formal RAND products for distribution to appropriate external audiences. The draft could be considered similar to an academic discussion paper. Although unrestricted drafts had been approved for circulation, they were not usually formally edited or peer reviewed.
This research in the public interest was supported by RAND, using discretionary funds made possible by the generosity of RAND's donors, the fees earned on client-funded research, and independent research and development (IR&D) funds provided by the Department of Defense.
Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.