HSR paper estimates ACA exclusions due to documentation status

09/26/14  Portland, Ore.

Model looks at adults whose immigration status excludes them from Medicaid and federal/state exchanges

As many as 3.5 million nonelderly adults could be excluded from the ACA Medicaid Expansion and 2 million from the health insurance exchanges because of their immigration status, and the proportion varies across states, according to a September 26th paper coauthored by CHSE's Peter Graven in Health Services Research.

The work drew on data from both the Census Bureau's Survey of Income and Program Participation (SIPP), which includes questions on immigration status, and the Bureau's American Community Survey (ACS) and Current Population Survey (CPS), which don't. The team used multiple imputation to incorporate model-based uncertainty into the prediction of immigration status into the ACS from the SIPP.  

Policy-makers need to factor in these excluded populations when estimating the impact of the ACA on health coverage rates in the United States, the authors conclude.