Another health insurance gap: Gaining and losing coverage among natives and immigrants at older ages

• We use SIPP 2004–2008 to examine health insurance transitions among older immigrants.
• Health insurance coverage for older immigrants is both less likely and more episodic.
• Fulltime employment is less protective for immigrants than natives for health insurance coverage.
• Without policy reform, changing age structure of immigrants will amplify this problem.

As the immigrant population grows older and larger, limitations on access to health insurance may create a new subgroup of people who remain outside or on the margin of coverage. Using the Survey of Income and Program Participation (SIPP) data from the 2004 and 2008 panels, we address the health insurance gap between foreign-born and native-born adults among those aged 50–64 and the 65 and older, two sub-populations that have received relatively little attention in past research. We argue that current practices leave a significant minority of older foreign-born residents inconsistently covered or without any insurance. We find that health insurance coverage for older immigrants is both less likely and more episodic even when compositional differences in SES and assimilation are controlled.