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Author: Rutledge, Matthew S. ; McLaughlin, Catherine
Working Paper: Decomposing The Growing Disparity In Health Insurance. Coverage Between Hispanics And Non-Hispanic Whites (PDF) ; 3/2008

The percentage of non-Hispanic Whites without health insurance has fallen slightly since the early 1980’s, and the rate for other racial groups has remained stable. Meanwhile, the uninsured rate among Hispanics has increased dramatically. In this paper, we estimate how differences between the two groups in citizenship, education, public coverage eligibility, income, and labor market participation have contributed to the increasing gap in health insurance coverage.  Pooling panels of the Survey of Income and Program Participation to gather over twenty years of monthly data, we estimate the extent of the contribution of these factors using two different methods: (1) the statistical significance of the trend line in the uninsured rate gap, regression-adjusted for each variable sequentially, and (2) pairwise Blinder-Oaxaca-style decomposition of the change in the gap between 1984 and each year thereafter. We find that, consistent across decomposition method, more than 70 percent of the increase in the gap, or between 2.5 million  and 4.9 million extra uninsured Hispanics, remains unexplained. While differences in observables account for most of the divergence in the public coverage and employer-sponsored coverage rates, a substantial portion of the relative decline in coverage through a family member remains unexplained. We suggest that job composition, social networks, risk tolerance, and healthy quality may, even controlling for factors that the literature has shown to explain coverage disparities, make Hispanics (particularly those of Mexican origin) less likely to seek, or be able to find, health insurance coverage than white non-Hispanics.