Determinants of private health insurance coverage among Mexican American men 2010–2013

Abstract

Background: Private health insurance (PHI) represents the largest source of insurance for Americans. Hispanic Americans have one of the lowest rates of PHI coverage. The largest group in the US Hispanic population are Mexican Americans; they account for about two in every three Hispanics. One in every three Mexican Americans aged 64 years and under did not have health insurance coverage. Mexican Americans have the most unfavorable health insurance coverage of any population group in the nation. Objectives: The objective is to determine the factors associated with the gap in PHI coverage between Mexican American and non-Hispanic American men. Methods: This study used the National Health Interview Surveys (2010–2013) as the sample. A non-linear Oaxaca-Blinder decomposition was run, estimating the explained and unexplained gap in PHI coverage between the groups. Several robustness tests of the model were also included. Results: This study estimates that 44.4% of employed Mexican American men are covered by PHI compared to 79.5% of non-Hispanic American men. Nearly 60% of employed Mexican American men were found to be foreign born, 35% have an educational attainment less than a high school degree, and 40% are likely to have language barriers. Decomposition results show that income, low educational attainment, being foreign-born, and language barriers diminished the probability of private health insurance coverage for Mexican Americans, and that 10% of the gap is unexplained. Conclusions: Most of the difference in the PHI rate between Mexican American men and non-Hispanic men is explained by observable differences in group characteristics: education, language, and immigration status. About 10% of the difference can be attributed to discrimination under the traditional interpretation of an Oaxaca-Blinder decomposition. The PHI rate gap is large and persistent for Mexican American men.