Is What I Hear True?

I heard that...

...healthcare services for illegal immigrants are costing the healthcare system a lot of money. Is that true?

This does not seem to be true. Although many people think illegal immigrants use the healthcare system more and don't pay for care, the data show that for the country as a whole, immigrants use the healthcare system less and cost the system less than people born in the U.S. This can vary by region, however, especially for regions with larger immigrant populations.

About half of American adults (52%) are concerned that immigrants “are a burden because they take jobs, housing, and health care [sic],” according to a Pew Research Center poll conducted in March 2006. This is up from 38% in September 2000 (Pew Research Center for the People and the Press & Pew Hispanic Center, 2006). There is a perception that undocumented immigrants use the healthcare system—and especially hospital emergency rooms—without paying for that care. In fact, federal law does require that hospitals treat emergency medical needs regardless of citizenship, place of residence, or ability to pay (Janofsky, 2003; Kaiser Family Foundation, 2003).

As a percentage of our national healthcare costs, immigrants cost a relatively small amount. However, immigrant healthcare costs are a significant burden for some states and cities that have large populations of immigrants who are in the country illegally – known as undocumented or illegal immigrants.
There were about 37.9 million immigrants in the United States in 2007, and an estimated 11-12 million of these immigrants were undocumented.

Getting accurate data about the cost of healthcare for undocumented immigrants is difficult, in part because of the legal consequences a person faces if he or she is identified as an undocumented immigrant. Nevertheless, some researchers have developed estimates of these costs. The estimates, however, often vary considerably from each other because of different interpretations of available data.

What is known is that healthcare spending on immigrants--both legal and undocumented--is a relatively small portion of total healthcare spending in the U.S. Research has also shown that immigrants, whether legal or undocumented, use the healthcare system less and cost it less per person than native-born Americans (Mohanty et al., 2005). Although the estimates vary, most researchers estimate that immigrant healthcare accounts for less than 5% of the total healthcare costs in this country (National Immigration Law Center, 2004). This percentage is significantly less than the proportion of immigrants in the population – about 13% (Camarota, S. A., 2007).

Some of the healthcare spending on immigrants, including undocumented ones is covered by health insurance. In fact, many undocumented immigrants have health insurance through employment, and they pay income, Social Security, and Medicare taxes. The estimates of the portion that have health insurance vary considerably between analyses, as do estimates of the difference between what undocumented immigrants pay in taxes and for healthcare and what they cost the government and the healthcare system for healthcare and other benefits (Passel & Cohn, 2009).

However, one recent study found that 44% of immigrants who had been in the U.S. for 10 years or less had health insurance and that it was likely that a significant portion of these were undocumented. About 63% of legal immigrants who had been in the country more than 10 years had health insurance (Ku, 2009).

These are national data, however, and do not take into account the effect of immigrants on local healthcare systems. Slightly more than half of all undocumented immigrants live in California, Texas, Florida, and New York and they put a significant burden on the healthcare systems in these states for care that is not paid for (uncompensated care) (Federation for American Immigration Reform, 2008; Janofsky, 2003; Passel & Cohn, 2009). According to American Hospital Association estimates, in 2000 the 24 southernmost counties along the U.S. border from California to Texas “accrued $832 million in unpaid medical care, a quarter of which was directly attributable to illegal immigrants” (Janofsky, 2003; Kaiser Family Foundation, 2003).

Sources

Camarota, S. A. (2007). Immigrants in the United States, 2007: A Profile of America's Foreign-Born Population. Washington, D.C.: Center for Immigration Studies.

Federation for American Immigration Reform. (2008). How Many Illegal Immigrants? Federation for American Immigration Reform, http://www.fairus.org/site/News2?page=NewsArticle&id=16859&security=1601&news_iv_ctrl=1007.

Janofsky, M. (April 14, 2003). Burden Grows for Southwest Hospitals. New York Times, http://www.nytimes.com/2003/04/14/health/14HOSP.html .

Ku, L. (2009). Health Insurance Coverage and Medical Expenditures of Immigrants and Native-Born Citizens in the United States. American Journal of Public Health, 99(7).

Kaiser Family Foundation. (2003). Coverage and Access: Care of Undocumented Immigrants Straining Hospitals in Southwestern U.S.: Kaiser Family Foundation, http://www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=17166&dr_cat=3.
Passel, J. S., & Cohn, D. V. (2009). A Portrait of Unauthorized Immigrants in the United States. Washington, D.C.: Pew Hispanic Center, http://pewhispanic.org/files/reports/107.pdf.

Pew Research Center for the People and the Press, & Pew Hispanic Center. (2006). No Consensus on Immigration Problem or Proposed Fixes: America's Immigration Quandry. Washington, D.C.: Pew Research Center for the People and the Press and Pew Hispanic Center, http://pewhispanic.org/files/reports/63.pdf.

 

CONTACT US