Purpose: This longitudinal study examined the role of health insurance in access to health care among older immigrants. Design and Methods: Using data from the Second Longitudinal Study of Aging, the longitudinal trajectories of having a usual source of care were compared between 3 groups (all 70+ years): (a) late-life immigrants with less than 15 years of residence in the United States ("recent immigrants"; n = 133), (b) "earlier immigrants" (15 years or longer in the United States, n = 672), and (c) U.S. born (n = 8,642). A series of hierarchical generalized linear models were run to test the mediating relationship of health insurance between immigrant status and having a usual source of care. Results: Although the probabilities of having a usual source of care increased over time across all three groups, recent immigrants were less likely to have Medicare and private insurance over time; this in turn was related to lower probabilities of having a usual source of care (indirect relationship). There was no direct relationship between immigrant status and having a usual source of care. Implications: To prevent the use of more expensive forms of care in the long run, policy efforts should expand late-life immigrants' health insurance coverage by increasing affordable health insurance options. © The Author 2010. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.

immigrants Elderly Insurance Access to care Usual source of care

longitudinal study medically uninsured economics health care policy insurance health insurance human Longitudinal Studies Insurance Coverage statistics Aged Insurance, Health United States Humans male Emigrants and Immigrants female Aged, 80 and over Socioeconomic Factors socioeconomics Article migration Linear Models Health Policy statistical model Delivery of Health Care patient Health Services Accessibility primary health care health care delivery