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Redressing the Limitations of the Affordable Care Act for Mexican Immigrants Through Bi-National Health Insurance: A Willingness to Pay Study in Los Angeles

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Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

The 12.4 million Mexican migrants in the United States (US) face considerable barriers to access health care, with 45 % of them being uninsured. The Affordable Care Act (ACA) does not address lack of insurance for some immigrants, and the excluded groups are a large proportion of the Mexican–American community. To redress this, innovative forms of health insurance coverage have to be explored. This study analyses factors associated with willingness to pay for cross-border, bi-national health insurance (BHI) among Mexican immigrants in the US. Surveys were administered to 1,335 Mexican migrants in the Mexican Consulate of Los Angeles to assess their health status, healthcare utilization, and willingness to purchase BHI. Logistic regression was used to identify predictors of willingness to pay for BHI. Having a job, not having health insurance in the US, and relatives in Mexico attending public health services were significant predictors of willingness to pay for BHI. In addition, individuals identified quality as the most important factor when considering BHI. In spite of the interest for BHI among 54 % of the sampled population, our study concludes that this type of coverage is unlikely to solve access to care challenges due to ACA eligibility among different Mexican immigrant populations.

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Acknowledgments

We are grateful to the Mexican Ministry of International Relations, the Institute for Mexicans Abroad and the Mexican Consulate in Los Angeles for facilitating the implementation of the study. We thank comments to an earlier draft by Xóchitl Castañeda, Steven Wallace and Adrián Dávila. We acknowledge the financial support from the Research Program on Migration and Health (PIMSA), contract number #INN01D.

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Authors and Affiliations

  1. Health Systems Research Center, National Institute of Public Health, Mexico, Av. Universidad no. 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, CP 62100, Mexico

    Miguel Angel González Block

  2. Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South Room 31-299C, Box 951772, Los Angeles, CA, 90095, USA

    Arturo Vargas Bustamante

  3. Population Health Research Center, Public Health Institute of Mexico, Av. Universidad no. 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, CP 62100, Mexico

    Luz Angélica de la Sierra

  4. Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Aresha Martínez Cardoso

Authors
  1. Miguel Angel González Block
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  2. Arturo Vargas Bustamante
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  3. Luz Angélica de la Sierra
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  4. Aresha Martínez Cardoso
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Correspondence to Arturo Vargas Bustamante.

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González Block, M.A., Vargas Bustamante, A., de la Sierra, L.A. et al. Redressing the Limitations of the Affordable Care Act for Mexican Immigrants Through Bi-National Health Insurance: A Willingness to Pay Study in Los Angeles. J Immigrant Minority Health 16, 179–188 (2014). https://doi.org/10.1007/s10903-012-9712-5

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  • DOI: https://doi.org/10.1007/s10903-012-9712-5

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