The true cost of U.S. health care for immigrants
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The Bell Policy Center continues to deliver the facts behind the rhetoric on immigration issues.

In this piece, Bell Senior Policy Analyst Robin Baker, Ph.D., debunks the claim that immigrants, legal or otherwise, cost a bundle for subsidized health care.

Look for more information on immigration at the Bell's website:
www.thebell.org > Immigration

By Robin Baker

Immigrants are not the reason why health care costs so much today.

Yet Defend Colorado Now, a group opposing illegal immigration, plans to ask Colorado voters to approve a constitutional amendment to prevent these immigrants from receiving state and local government services.

The group argues, among other things, that health care costs for these immigrants come at the expense of U.S. citizens. While the rhetoric is hot, it is not accurate.

In fact, immigrants -- legal and undocumented -- use less subsidized health care than U.S. citizens, and the only subsidized health care available to undocumented immigrants is emergency treatment.

Immigrants are not driving up the costs of health care.
It's the growing number of uninsured citizens relying on emergency medical and charity care.

Legal immigrants use less subsidized care

To understand how much immigrants tap the U.S. health care system, a team of six university-based doctors analyzed a national survey of 21,000 people, including 2,800 immigrants. They found the immigrants received an annual per capita average of $1,139 worth of care, less than half the $2,564 in care for the U.S. citizens.
The doctors published their study results in the August 2005 issue of the American Journal of Public Health.

A separate study by the Center on Budget and Policy Priorities found that only 13 percent of qualified immigrant parents used Medicaid in 2001, compared to 22 percent of U.S. citizen parents.

Likewise, only 24 percent of qualified immigrant children used Medicaid compared to 47 percent of citizen children.
Legal immigrants who arrived after Aug. 22, 1996, are not eligible for Medicaid insurance for five years. After the five-year limit, their sponsor's income and assets are used to determine Medicaid eligibility.

Illegal immigrants: emergencies only

Undocumented immigrants are not, and never have been eligible for Medicaid insurance.
The only exception -- emergency medical care for a life-threatening injury or illness -- is mandated by the federal government. This only covers treatment to stabilize the patient. That means no follow-up, no rehabilitation and no drug treatment. A U.S. citizen in a similar situation would qualify for full Medicaid insurance benefits.

The U.S.-born children of undocumented immigrants may qualify for a wider array of Medicaid health care under strict family eligibility limits, but only the child's health care is covered.

Uninsured citizens a bigger burden

Because undocumented immigrants are only eligible for emergency medical care, their per-capita hospital costs are higher, but overall medical service costs are lower.

For hospitals, the real problem is the increasing numbers of uninsured patients seeking care combined with decreasing reimbursement for Medicaid patients.

The Government Accountability Office (GAO) noted in a 2004 report that hospitals don't usually ask patients their immigration status, so the extent of care for undocumented immigrants is unknown. The GAO estimates that more undocumented immigrants are seeking care, but these patients still represent a small share of total charity care.

The Kaiser Commission on Medicaid and the Uninsured notes that 19 percent of working-age U.S. citizens were uninsured in 2004.
Kaiser also found 40 to 50 percent of immigrants not naturalized are uninsured. But because they are just 8 percent of the U.S. population, they had little effect on the growth in uninsured people.

The U.S. Census Bureau estimated that in 2003, 88 percent of the U.S. residents were native born, 5 percent were foreign-born immigrants who became U.S. citizens, and 8 percent were documented or undocumented immigrants.

The proposed constitutional amendment to prohibit services for undocumented immigrants will not save the state money or reduce health care costs.

Colorado does not pay for non-emergency health services for immigrants. And because the federal government mandates emergency medical care, it is exempted under the proposed amendment.

The real problem with health care costs, which the proposal fails to solve, is that more and more people -- native or foreign born -- can't afford health care.

The proposed amendment relies on fear tactics and false assumptions. It certainly won't fix the U.S. health care crisis, but it blames hard-working immigrants who can't defend themselves against unfair charges and bad information.


Robin Baker, Ph.D., is a senior analyst for Bell Policy Center, a nonpartisan progressive think tank working on social public policy issues in Colorado. Contact her at baker@thebell.org.

Reader Comments
  
This is great work, Heather
By Bobby Mar 17th 2006 at 7:18 am MST
Thanks to everyone over there for getting the facts out, again.
Re: This is great work, Heather
By Marcos Nelson Suarez Mar 23rd 2006 at 1:28 pm MST
I really don't understand how anyone could defend illegal immigration. We have a system where around 900,000 people came to the States every year.
Please, let's look for a legal, organized way to immigrate, but as long some people try to justify illegal immigration the issue will not be solved.
Re: This is great work, Heather
By Steve Jenkins Mar 30th 2006 at 4:59 pm MST
I have spoken to far too many Physicians, Nurses, and Pharmacists (I am a recruiter) to buy into believing that health care is NOT adversely affected by allowing illegals to take part.

Talk to any one in the hospital and they will more than likely have tons of stories to tell about how illegals are sapping resources at the expense of Americans.

A personal story. A year ago, my son cracked himself on the head while riding his mountain bike. I take him to the ER. People, his HEAD WAS BLEEDING!

Now, put yourself in the picture here. Let's say your child's head was bleeding.

We were just about ready to be ushered in----when a pregant woman, speaking no English (an illegal McDonald's worker) came in complaining of abdominal pain.

Guess who had to wait his turn? I still need someone to explain to me why my son's head wound was less of a priority.

Your tax dollars at work. And it isn't for citizens.

Report all illegal hiring.
  
Health Care for Illegals
By Dr. Norm Tempel Mar 18th 2006 at 1:50 pm MST
Sorry Heather. Your article is so full of holes it would require a significant amount of time to pull together information to provide clarity to the actual cost associated with illegal health care. For Example a true tracing of the costs associated with anchor babies. In addition the actual cost associated with emergency care versus charges recorded. The important point is that everyone knows American Health Care Costs cannot be directly attributed to illegals. However, for some states these costs when added to Welfare, police, criminal justice, etc. is a growing burden for the legal american tax payers. Why don't you spend your time supporting those who are trying to correct the illlegal immigration problem instead of
defending the illegals.
  
Health Care for Immigrants
By David S. Schneider Mar 21st 2006 at 12:49 pm MST
Heather, you know that in any issue "The Bottom Line is the Bottom Line. How can our government rationalize health care for certain "Protected Groups of People", while at the same time declaring others that are Native Born American Citizens or the 40 million or so that insurers REFUSE to provide coverage to by making it unaffordable them?

It seems to me that what we have here is a two tier medical system where the rich won't pay & the can't pay. Therefore, the financial burden is upon the traditional American Middle Class. Are we trying to decimate Middle America and replace it with a new middle class that is easily deceived & manipulated;a middle class that follows the European model in which government subsidies determine whether you're middle class-Methinks that this a social engineering concept that will eventually cripple the American Society for it rewards people for what God made them & not a True Contribution to the General Welfare of the Nation.
My point Heather, is that for 16 years the Democratic Party has taken a beating; if Dems hope to be in a position of leadership, they're going to have to Call Off Their Tired Ethic & start to listen to the voter base & quit letting Special Interest Group divide the party...No wonder people vote a Republican Ticket, I think we that are Dems collectively and individually need to get our heads out of our Kiesters and look at the Big Picture like F.D.R. & Harry S. Truman did.

P.S. "People vote with their wallet..."
Dr. Milton Friedman, Nobel Emaritus, Professor Emaritus, University of Chicago
  
Immigrantion reform
By Lois Hartman Mar 27th 2006 at 3:19 pm MST
Thank you for the information. I would like to sign but when I try to connect to the petition it says "invalid petition request" .
  
Health Care Use Among Undocumented Latino Immigrants
By Evergreen Peace Mar 27th 2006 at 6:29 pm MST
We may be tired but that doesn't mean our ethics are! ~Hannah

Health Care Use Among Undocumented Latino Immigrants

Is free health care the main reason why Latinos come to the
United States? A unique look at the facts.
by Marc L. Berk, Claudia L. Schur, Leo R. Chavez, and
Martin Frankel

excerpt from pages 10- 11

Our findings suggest that excluding undocumented immigrants from government-funded health care services is unlikely to affect immigration. This supports earlier studies indicating that mmigrants come to the United States primarily in search of employment. In a study of illegal immigrants who applied for legal status under the 1986 Immigration Reform and Control Act, 94 percent of respondents cited economic reasons for immigration.24 Similarly, Leo Chavez and colleagues found that social services did not influence Latina immigrants’ intentions to remain in the United States.25 It appears likely that only substantial changes in the relative economic opportunity available on either side of the border will influence the flow of persons crossing to the United States.

We found that the level of ambulatory health care received was
quite low among undocumented Latinos in the study sites. The high rate of childbirth among undocumented immigrants (and related use of hospital services) is probably related to the higher proportion of Latinas of childbearing age, the overall higher fertility rates among Latinos, and the fact that children born in the United States will become citizens. Thus, it is unlikely to decrease with changes in the availability of services. Since even current policy permits the provision of emergency services—including labor and delivery but excluding prenatal care—recent initiatives may have serious consequences not anticipated by the designers of such legislation.26 By not providing prenatal care and routine or preventive services, they are unlikely to see a decrease in the number of children born but likely to see a decrease in the relative number of healthy children born
instead.

Given today’s political climate there is little chance that legislators will offer funding to provide health care services to the undocumented immigrant population. Also, despite the dramatic improvements in access to care for low-income persons enrolled in public programs, it would be politically unacceptable to permit undocumented immigrants to enroll in Medicaid without expanding that program to other low-income persons who are U.S. citizens.27 At the same time, the reality of households with both undocumented and legal residents must be considered by those developing policies affecting immigrant households. Approximately half of undocumented Latino adults in the four study sites have at least one child who is a U.S. citizen. While children may be eligible for publicly funded services, the difficulty parents face in obtaining health care is likely to have a deleterious effect on their children’s economic and social well-being. Although policymakers may have a legitimate interest in constraining the use of services by undocumented immigrants, imposing additional constraints may be counterproductive in light of the minimal level of health care being used by that population.

Link
Re: Health Care Use Among Undocumented Latino Immigrants
By Alan Franklin Apr 2nd 2006 at 8:13 am MDT
Good stuff -- thanks for posting it.
Re: Health Care Use Among Undocumented Latino Immigrants
By adriana Apr 21st 2006 at 8:21 pm MDT
Im sorry to say this but you people are sooo ignorant. Why are we hating on illegal immigrants, I mean come on get over it they are here and they are here to stay, plus who are we as "Americans" to say that they are illegal excuse me but where their ancestors not here before us, YES!!! plus I dont see any of us and I include myself in this out in the fields working under the sun picking your food, yes sir, next time you bite into that carrot, cabbage, lettuce, cucumber, orange, broccoli, think about the illegal immigrant who picked that. And you dont even want to help them when they are at a health risk, I agree that illegal immigrants are not the reason for such high cost to our health programs, why instead of looking at the illegal immigrants dont we look at all the citizens who are taking advantage of governmet programs like welfare, as a tax payer, I am not very happy when at the super market I see a well abled body person paying with food stamps, all the while they are very well groomed with manicures and all, while the children whom they are supposed to be taking care of run amock in ragged clothing. Im gonna say it not only mexican people but people of all races do this and its driving me insane. At least the "immigrants" only "use up" our money when they are at health risk. And to answer the man who was asked to wait at the emergency room excuse me sir but did you not read the sign that said patients will be assisted according to the severity of their problem, that is not the mexican womans fault but your ER staff who chose to call her in first. By the way I fully support the hiring of immigrants by employees, I have worked with them and they are way better workers that us so called citizens.
  


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