Ponce Ninez, Nordyke Robert J, Hirota Sherry
Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA.
J Immigr Health. 2005 Jan;7(1):45-53. doi: 10.1007/s10903-005-1390-0.
We inform a county's efforts to provide health insurance to uninsured working immigrants-a group left out of national and state strategies that aim to expand coverage. We analyzed a population-based survey data administered in English, Spanish, Cantonese, Mandarin, Korean, Vietnamese, and Dari on 5,540 nonelderly adult workers in Alameda County, California. The study models the likelihood of employment-based coverage, estimates the eligibility for public programs, and evaluates the affordability of average employee share of premiums by citizenship status and years lived in the United States (tenure). Immigrant workers in Alameda County are disproportionately uninsured. They constitute 29% of the employee labor force but 54% of uninsured employees. Employment-based coverage increased with citizenship and length of stay (tenure) in the United States. Noncitizens with less than 5 years residency in the United States faced the greatest disadvantage in securing employment-based coverage, an effect that is greater than disadvantages associated with race/ethnicity. A citizenship-tenure divide existed in obtaining employment-based coverage, suggesting that policies focusing on noncitizen and new immigrant workers would greatly relieve the disparate uninsured rates among workers. The expansion of nonemployment-based coverage programs would cover more than 30% of Alameda County's uninsured immigrant workers; but subsidies will also be needed for the lowest-income workers who are not eligible for these programs.
我们介绍了一个县为未参保的在职移民提供医疗保险的努力，这一群体被旨在扩大医保覆盖范围的国家和州战略所遗漏。我们分析了一项基于人群的调查数据，该调查以英语、西班牙语、粤语、普通话、韩语、越南语和达里语对加利福尼亚州阿拉米达县的5540名非老年成年工人进行了调查。该研究对基于就业的医保覆盖可能性进行了建模，估计了公共项目的资格，并按公民身份和在美国居住的年限（居留期）评估了员工平均保费份额的可承受性。阿拉米达县的移民工人未参保的比例过高。他们占员工劳动力的29%，但占未参保员工的54%。基于就业的医保覆盖随着公民身份和在美国停留的时间（居留期）增加。在美国居住不到5年的非公民在获得基于就业的医保覆盖方面面临最大劣势，这种影响大于与种族/族裔相关的劣势。在获得基于就业的医保覆盖方面存在公民身份 - 居留期差异，这表明关注非公民和新移民工人的政策将极大缓解工人中不同的未参保率。扩大非基于就业的医保覆盖项目将覆盖阿拉米达县超过30%的未参保移民工人；但对于不符合这些项目资格的低收入工人也需要补贴。
