25
          
        
        
          
            Chapter II
          
        
        
          
            Access toHealth Insuranceand ServiceUse
          
        
        
          The analysis compares the situation in 2004
        
        
          with that in 2013, based on data from the
        
        
          
            Current
          
        
        
          
            Population Survey
          
        
        
          (cps) and the
        
        
          
            National Health
          
        
        
          
            Interview Survey
          
        
        
          (nhis).
        
        
          1
        
        
          The impact of the imple-
        
        
          mentationof theacawill be reflected in the resultsof
        
        
          surveys undertakenafter 2013.
        
        
          
            Coverageandtype
          
        
        
          
            ofhealth insurance
          
        
        
          
            Approximately6.2millionMexican
          
        
        
          
            immigrants lackhealth insurance
          
        
        
          Mexican immigrants face a series of obstacles that
        
        
          restrict their access to awide array of services for the
        
        
          prevention, diagnosis, treatment and rehabilitation
        
        
          of illnesses. This has negative consequences for their
        
        
          health, both physical and mental, and exacerbates
        
        
          theirmarginalized condition in theUnitedStates.
        
        
          In 2013, approximately 6.2 million Mexican
        
        
          immigrants were living in the United States without
        
        
          health insurance, a figure that has decreased since
        
        
          2007, likelydue to thedecrease in theundocumented
        
        
          population (Figure11).
        
        
          1
        
        
          Given the limitations of the NHIS sample size, which prevent stable
        
        
          estimates for a single year, the periods 2004-2005 and 2012-2013
        
        
          were analyzed.
        
        
          
            Introduction
          
        
        
          Mexican immigrants in the United States face consi-
        
        
          derable difficulties in receiving health care, which can
        
        
          haveanegativeeffect on their physical andemotional
        
        
          health. The exclusion of a considerable segment of
        
        
          this population from health insurance coverage re-
        
        
          flects their disadvantage in terms of labor and social
        
        
          integration, and limits their ability to use health care
        
        
          services appropriately.
        
        
          The
        
        
          
            Patient Protection and Affordable Care
          
        
        
          
            Act
          
        
        
          (aca), whose major provisions took effect in
        
        
          2014, isexpected to increase thenumberofMexican
        
        
          immigrants with health insurance coverage. However,
        
        
          given that over half of those with undocumented
        
        
          status areMexican, a significant segment will remain
        
        
          excluded (see box I). This chapter compares immi-
        
        
          grant populations from Mexico, Central America
        
        
          and other regions with US-born whites and African
        
        
          Americans, and highlights the differences in terms of
        
        
          health insurance coverage and use of health services.
        
        
          It also explores the relationships between coverage
        
        
          and the different situations directly linked to themi-
        
        
          grant experience, such as length of stay and citizen-
        
        
          ship status. It also shows the disadvantages faced by
        
        
          Mexican and Central Americanmigrants to receiving
        
        
          timely health care in theUnited States.