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The deadly effects of losing health insurance

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  • Juanmarti Mestres, Arnau
  • López Casasnovas, Guillem
  • Vall Castelló, Judit

Abstract

The number of undocumented migrants in developed countries has increased in recent years, which has generated discussions about the extent to which access to public programs should be restricted for this population. This is the first paper that estimates the effects of restricting access to one of these public programs, health care, on mortality rates of undocumented immigrants. We exploit the natural experiment that arises from a reform implemented in Spain in September 2012 that introduced this restriction. We show that, during the first three years of implementation, the restriction increased the monthly mortality rate of undocumented immigrants by 0.31 deaths per 100,000 individuals (which corresponds to 82 additional deaths each year). We also document small changes in the composition of the treated population with 5% of middle educated individuals being substituted by lower educated ones. However, this selective migration can only account for 3.45% of our mortality effects. Our results show the large effects of health insurance coverage on the health status of vulnerable populations and have important policy implications for developed countries currently receiving sizeable migration flows.

Suggested Citation

  • Juanmarti Mestres, Arnau & López Casasnovas, Guillem & Vall Castelló, Judit, 2021. "The deadly effects of losing health insurance," European Economic Review, Elsevier, vol. 131(C).
    • Handle: RePEc:eee:eecrev:v:131:y:2021:i:c:s0014292120302385
    DOI: 10.1016/j.euroecorev.2020.103608
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    2. Catia Batista & Ana Beatriz Gomes, 2022. "Healthcare assimilation of immigrants," NOVAFRICA Working Paper Series wp2208, Universidade Nova de Lisboa, Nova School of Business and Economics, NOVAFRICA.
    3. Allen, William L. & Ruiz, Isabel & Vargas-Silva, Carlos, 2024. "Policy preferences in response to large forced migration inflows," World Development, Elsevier, vol. 174(C).
    4. Daniel Sebastian Tello‐Trillo, 2021. "Effects of losing public health insurance on preventative care, health, and emergency department use: Evidence from the TennCare disenrollment," Southern Economic Journal, John Wiley & Sons, vol. 88(1), pages 322-366, July.
    5. Mengna Luan & Wenjing Shi & Zhigang Tao & Hongjie Yuan, 2023. "When patients have better insurance coverage in China: Provider incentives, costs, and quality of care," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 31(4), pages 1073-1106, October.

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    More about this item

    Keywords

    Health insurance; Undocumented immigrants; Mortality rates;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination

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