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The University of Texas at Austin

Lyndon B. Johnson School of Public Affairs




Conference Paper

Hispanics, Health Insurance, and the Pact between the Generations



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Professor of Public Affairs
and Sociology

The United States faces major challenges in financing the retirement and health care needs of future generations. Although addressing such problems will be painful in the short-term, the crisis is historically unique and limited. As the baby boomers pass from the scene, so will the crisis. But, perhaps a far more serious potential problem arises from the ethnic and racial overlay to the age-grading of our society. Today’s Hispanics, for example, will be tomorrow’s majority in many states, and they will make up a major part of the U.S. labor force. This fact raises many issues of critical importance to health policy makers, providing the primary focus of the paper for the LBJ Centennial Celebration. The proposed research explores how labor force vulnerabilities affect the overall well-being of the Hispanic population with a specific focus on health insurance. The uninsured rates for Hispanics were the highest among any American minority group in 2005 (33.7% versus 19.6% for African Americans and 16.9% for Asian Americans, respectively). Most disturbingly, the number of Hispanics who lack coverage is swiftly increasing, climbing from 13.5 million to 14.1 million persons between 2004 and 2005.

Surprisingly, scant research has probed deeply into the ways in which work-related policy mechanisms may explain such vulnerability even though an abundance of studies document the dismal situation of Hispanic’s access to health insurance. The neglect in research along these lines is puzzling because it is well known that the employment based health insurance system of the United States means that those individuals who are disadvantaged in the labor market are also disadvantaged in terms of health insurance coverage. Hispanics, and especially those of Mexican-origin, have historically been disadvantaged in both domains. Throughout the life course Mexican-origin individuals and families have lower rates of health insurance coverage than non-Hispanic white or other minority group members. Many explanations for these low rates of coverage have been offered, including employment in jobs in which coverage is not offered, the high cost of family coverage, bureaucratic barriers to the access of public coverage, language difficulties, and more. The most immediate source of the vulnerability of the Mexican-origin population relates to their location in the labor force.

This study employs data from the 2004 and 2006 Current Population Surveys (CPS) to examine the role of employment in explaining differences in rates of health insurance coverage among employed Mexican-origin, African-American, and non-Hispanic white workers. The ultimate objective in this analysis is to determine the extent to which low rates of health insurance coverage among Mexican-origin workers 18 to 64 are the result of overrepresentation in occupational sectors in which coverage is low for everyone. If the differential observed in the aggregate disappears or is at least the same magnitude, among individuals in particular occupations, a distributional effect exists− penalized equally. On the other hand, if the differential persists then some other factors may be accounting for the difference.

We expect the results to make clear whether the health insurance vulnerability of the Mexican-origin population reflects multiple barriers to coverage in addition to those related to occupational concentration. The paper ends with a “Call for Action” to consider the increasing significance of Hispanic ethnicity in the nation’s social policy agenda. The failure to do so runs the risk of introducing a dimension of racial and ethnic strife into what could be serious age-based conflicts since the Great Society era.

Click here to download a PDF of the full paper.

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