Welfare Reform and Older Immigrant Adults’ Medicaid and Health Insurance Coverage
Welfare Reform and Older Immigrant Adults’ Medicaid and Health Insurance Coverage
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福利改革和老年移民的医疗补助和健康保险覆盖范围
作者：
Y. Nam
目的：研究联邦非公民医疗补助资格限制和慷慨的州政策如何影响具有不同公民身份的老年人的医疗补助和健康保险覆盖范围。方法：这项研究使用了来自当前人口调查（CPS）和州数据的老年人样本（65岁或以上），并采用了三重差异的方法来纳入公民身份，时间和州资格的变化。结果如下：研究结果表明，医疗补助覆盖率显着下降，老年非公民，但增加了老年入籍公民福利改革后。研究结果还表明，在慷慨和非慷慨的国家之间，老年非公民的医疗保险覆盖范围的变化差异显着。讨论：医疗补助资格影响老年移民成年人的医疗补助和健康保险范围。研究结果支持“保护公民”的假设，但不是“寒蝉效应”和“劳动力市场条件”的假设。入籍公民和非公民之间医疗补助覆盖范围的相反变化模式引起了人们对资格限制在减少政府支出方面的有效性的怀疑。
Objectives: To examine how federal noncitizen Medicaid eligibility restriction and generous state policy affect Medicaid and health insurance coverage among older adults with different citizenship status. Method: This study uses an older adult sample (65 years or older) from the Current Population Survey (CPS) and state data and employed a triple difference-in-differences approach to incorporate variations in citizenship status, time, and state eligibility. Results: Findings show that Medicaid coverage significantly declined among older noncitizens but increased among older naturalized citizens after Welfare Reform. Findings also show that the differences in older noncitizens’ health insurance coverage changes were significant between generous and nongenerous states. Discussion: Medicaid eligibility affects older immigrant adults’ Medicaid and health insurance coverage. Findings support the “protective citizenship” hypothesis but not the “chilling effect” and “labor market condition” hypotheses. Opposite patterns of change in Medicaid coverage between naturalized citizens and noncitizens raise doubt about the effectiveness of eligibility restrictions in reducing government spending.