Objectives. I examined changes in older immigrants' health insurance coverage after welfare reform in the United States to determine whether the reform measures achieved their goal of saving money by reducing Medicaid participation without increasing the number of uninsured people. Methods. Data were obtained from older adults who participated in the Current Population Survey's Annual Social and Economic Supplement from 1994 to 1996 and 2001 to 2005. I used logistic regression to estimate changes in the sample's Medicaid and health insurance coverage after welfare reform, paying special attention to noncitizens and recent immigrants. Results. Older immigrants' health insurance status was associated with their citizenship status and length of stay in the United States. Medicaid participation significantly decreased among noncitizens and recent immigrants but increased among naturalized citizens. Private health insurance and employer-sponsored insurance coverage significantly increased among recent immigrants but decreased among established immigrants and naturalized citizens. The probability of being uninsured did not significantly change among any group of immigrants. Conclusions. Given increases in postreform Medicaid participation among some immigrant groups, my findings suggest that the long-term cost-saving effectiveness of the current restrictive Medicaid eligibility policy is doubtful.

[No Keywords available]

evaluation immigrant Cost benefit analysis economics logistic regression analysis health care policy demography insurance health insurance employer human Insurance Coverage aging statistics controlled study probability Aged Logistic Models length of stay health care distribution social care Insurance, Health Eligibility Determination family size ethnology private health insurance Family Characteristics interview United States Humans classification health services research Interviews as Topic male Emigrants and Immigrants female Aged, 80 and over health plan employer data and information set social welfare Article organization and management adult migration legal aspect medicaid normal human statistical model Public Assistance Health Care Reform cost-benefit analysis medical care citizenship Health Services for the Aged elderly care cost effectiveness analysis health survey