Immigration Status and Health Insurance Coverage: Who Gains? Who Loses?

OBJECTIVES: We compared health insurance status transitions of nonimmigrants and immigrants. METHODS: We used multivariate survival analysis to examine gaining and losing insurance by citizenship and legal status among adults with the Los Angeles Family and Neighborhood Survey. RESULTS: We found significant differences by citizenship and legal status in health insurance transitions. Undocumented immigrants were less likely to gain and more likely to lose insurance compared with native-born citizens. Legal residents were less likely to gain and were slightly more likely to lose insurance compared with native-born citizens. Naturalized citizens did not differ from native-born citizens. CONCLUSIONS: Previous studies have not examined health insurance transitions by citizenship and legal status. Policies to increase coverage should consider the experiences of different immigrant groups.