Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #143 

September 2006 

Health Insurance Status of Hispanic 

Subpopulations in 2004: Estimates for 

the U.S. Civilian Noninstitutionalized 

Population under Age 65 

Highlights 

 In 2004, Hispanics had the 

highest rate of being uninsured of all racial/ethnic 

groups. More than one in 

three Hispanics (36.2 

percent) were uninsured 

throughout the first half of 

the year. 

 Puerto Ricans were the most

likely of all Hispanic subgroups to be enrolled in 

public only health insurance

and the least likely to be uninsured. In 2004, 37.8 

percent of Puerto Ricans 

had public only health insurance as their only source of

coverage, and 16.0 percent 

were uninsured. 

 Mexicans (36.4 percent) 

were less likely to have 

private coverage than other 

Hispanic subgroups (43.8 

percent). 

 Hispanics who were not 

U.S. citizens were more 

than twice as likely to be 

uninsured as those who 

were citizens.

Jeffrey A. Rhoades, PhD and Jessica P. Vistnes, PhD 

Introduction 

Government statistics on health insurance often present estimates 

for the Hispanic population as a whole. For many years, these estimates have revealed that the Hispanic population has the highest 

rate of being uninsured of all racial/ethnic subgroups in the United 

States. 

Using data from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC), this Statistical Brief presents health 

insurance estimates for the Hispanic population by subgroups and 

U.S. citizenship status. An examination of these estimates reveals 

dramatic disparities in insurance coverage within the Hispanic 

population due to differences in eligibility for public programs and 

access to private coverage. 

All differences between estimates discussed in the text are 

statistically significant at the 0.05 level unless otherwise noted. 

Findings 

Hispanics had the highest rate of being uninsured of all racial/ 

ethnic groups. In 2004, 36.2 percent of Hispanics were uninsured

throughout the first half of 2004 compared with 14.5 percent for nonHispanic whites, 21.9 percent for non-Hispanic blacks, 17.4 percent

for non-Hispanic Asian and Pacific Islanders, and 22.5 percent for 

non-Hispanic other races/multiple race individuals (figure 1). 

Puerto Ricans had the highest rate of public only coverage (37.8 percent) among the Hispanic 

subpopulations (figure 2). This is not surprising, given that persons born in Puerto Rico are American 

citizens and thus do not have to become legal residents to gain access to public only health insurance.* 

However, even those Mexicans (29.8 percent) and other Hispanics (26.1 percent) who were citizens were 

less likely to have public only coverage than Puerto Ricans. Noncitizen Mexicans and other Hispanics 

had even lower rates of public only coverage than citizens (11.5 and 12.4 percent, respectively). 

*Vitullo, M. and Taylor, A. Latino Adults' Health Insurance Coverage: An Examination of Mexican and Puerto Rican Subgroup 

Differences. Journal of Health Care for the Poor and Underserved. 2002, 13(4), 504–525. 
Mexicans (36.4 percent) had the lowest rate of private coverage among the Hispanic subgroups (figure 

3). This was mainly due to the large proportion of Mexicans who were not U.S. citizens and who had very 

low rates of private coverage (21.6 percent). Hispanics who were citizens in all subgroups had similar 

rates of private coverage (between 43.0 and 47.6 percent). Other Hispanics who were noncitizens also 

had lower rates of private coverage than their citizen counterparts (37.1 percent versus 47.6 percent, 

respectively). 

Puerto Ricans’ high rate of public only coverage contributed to their having the lowest rate of uninsurance 

among all Hispanic subgroups. Only 16.0 percent of Puerto Ricans were uninsured compared with 39.5 

and 35.1 percent, respectively, of Mexicans and other Hispanics (figure 4). Mexicans and other 

Hispanics who were not U.S. citizens were more than twice as likely to be uninsured as those who were 

citizens. Two-thirds of noncitizen Mexicans were uninsured (67.0 percent) compared with 27.2 percent of 

citizens. Noncitizen individuals in the other Hispanic subgroup were also much more likely to be 

uninsured than their citizen counterparts (50.5 percent versus 26.3 percent, respectively) (figure 4). 

Data Source 

The estimates shown in this Statistical Brief are drawn from analyses conducted by the MEPS staff from 

the 2004 point-in-time public use file: HC-075. U.S.-born status was derived by linkage of the MEPS 

sample to the 2003 National Health Interview Survey sponsored by the National Center for Health 

Statistics. 

Definitions 

Uninsured 

Individuals classified as uninsured throughout the first half of the year did not have public only or private 

health insurance coverage during the period from January of the survey year through the time of their first 

interview in that year. Interviews were typically conducted from February to June. Individuals covered only 

by noncomprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private 

single-service plans (e.g., coverage for dental or vision care only, coverage for accidents or specific 

diseases) were considered to be uninsured. 

 

Public only coverage 

Individuals were considered to have public only health insurance coverage if they were not covered by 

private insurance and they were covered by Medicare, Medicaid, TRICARE, or other public only hospital 

and physician coverage. 

Private coverage 

Private health insurance coverage was defined as nonpublic insurance that provided coverage for 

hospital and physician care (including Medigap coverage). 

Race/ethnicity 

Classification by race/ethnicity was based on information reported for each family member. Respondents 

were asked if each family member's race was best described as American Indian, Alaska Native, Asian or 

Pacific Islander, black, white, or other. They also were asked if each family member's main national origin 

or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin 

American; or other Spanish. All persons whose main national origin or ancestry was reported in one of 

these Hispanic groups, regardless of racial background, were classified as Hispanic. Since the Hispanic 

grouping can include black Hispanic, white Hispanic, Asian and Pacific Islanders Hispanic, and other 

Hispanic, the race categories of black, white, Asian and Pacific Islanders, and other do not include 

Hispanic. MEPS respondents who reported other single or multiple races and were non-Hispanic were 

included in the other category. For this analysis, the following classification by race and ethnicity was 

used: Hispanic (of any race), non-Hispanic blacks, non-Hispanic whites, non-Hispanic Asian and Pacific 

Islanders, non-Hispanic others, Puerto Ricans, Mexicans, and other Hispanic. 

Note: The MEPS sample does not include Puerto Rico, but rather Puerto Ricans living in the contiguous 

United States. 
Citizenship status 

Citizenship status was imputed for approximately 15 percent of the sample. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Rhoades, J. A. and Vistnes, J. P. Health Insurance Status of Hispanic Subpopulations in 2004: Estimates 

for the U.S. Civilian Noninstitutionalized Population under Age 65. Statistical Brief #143. September 2006. 

Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/mepsweb/ 

data_files/publications/st143/stat143.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2004 Point-in-Time File

Figure 1. Percentage uninsured, by race/ethnicity,

people under age 65, first half of 2004

21.9

17.4

36.2

22.5

14.5

0

15

30

Hispanic White nonHispanic, single

race

Black nonHispanic, single

race

Asian or Pacific

Islanders nonHispanic, single

race

Other

races/multiple

race, nonHispanic

Percent

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2004 Point-in-Time File

Figure 2. Percentage with public only health insurance, by Hispanic

subgroup and citizenship, people under age 65, first half of 2004

24.1

21.1

29.8

26.1

11.9 11.5 12.4

37.8

24.8

30.1

0

10

20

30

40

All Hispanics Puerto Rican Mexican Other Hispanic

Total Citizen Not Citizen

Percent

Note: Since persons born in Puerto Rico are American citizens, virtually all Puerto Ricans in the sample are citizens; a few may have

been misclassified due to possible respondent error. Therefore, a total estimate only is provided for the Puerto Rican subgroup.
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2004 Point-in-Time File

Figure 3. Percentage with private insurance, by Hispanic

subgroup and citizenship, people under age 65, first half of 2004

36.4

43.8 43.0

47.6

25.4

21.6

37.1

46.2

39.0

44.4

0

10

20

30

40

50

All Hispanics Puerto Rican Mexican Other Hispanic

Total Citizen Not Citizen

Percent

Note: Since persons born in Puerto Rico are American citizens, virtually all Puerto Ricans in the sample are citizens; a few may have

been misclassified due to possible respondent error. Therefore, a total estimate only is provided for the Puerto Rican subgroup.

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2004 Point-in-Time File

Figure 4. Percentage uninsured, by Hispanic subgroup and 

citizenship, people under age 65, first half of 2004

39.5

35.1

27.2 26.3

62.2

67.0

50.5

16.0

36.2

25.5

0

10

20

30

40

50

60

70

All Hispanics Puerto Rican Mexican Other Hispanic

Total Citizen Not Citizen

Percent

Note: Since persons born in Puerto Rico are American citizens, virtually all Puerto Ricans in the sample are citizens; a few may have

been misclassified due to possible respondent error. Therefore, a total estimate only is provided for the Puerto Rican subgroup.