Changes in Health Insurance Coverage and Health Status: DISCUSSION

Posted by James

The expansion of Medicaid and the creation of SCHIP between 1997 and 2002 effectively increased public health insurance coverage of both children and adults. Uninsurance rates were reduced significantly for black, Hispanic and white children in low-income families. Black and white adults experienced no change in uninsurance during this period. The share of Hispanic adults without health insurance, however, increased significantly. Compared to black or white adults, Hispanic adults gained less in the expansion of public coverage, for which many Hispanic adults were (or believed themselves to be) ineligible due to restrictions on benefits for nonciti-zen immigrants. Hispanic adults were also the only group to see a drop in employer-sponsored coverage. Immigrants are less likely to be offered employer-sponsored health insurance than native-born workers, and the proportion of Hispanic adults born outside the United States increased during this period.

Despite the gains for low-income black and Hispanic children, racial and ethnic disparities in insurance coverage and in respondent-reported health status persist. Among children and adults alike, Hispanics consistently fared worse than blacks or whites in both insurance coverage and health status, and blacks fared worse than whites. Hispanics are the largest and fastest-growing racial or ethnic minority in the United States, accounting for 13% of the population today and expected to reach 33% by the end of the century. The non-Hispanic black population is projected to grow slightly, from 12% to 13%, over the same period. Non-Hispanic whites, in contrast, make up 68% of the population today but will make up only 40% in 2100. If policymakers allow current disparities to continue, the health of the nation may deteriorate as the composition of the population changes. canadian antibiotics