Challenging assumptions about immigrants’ health care spending

One week ago, Project HOPE published a study based on the publicly accessible figures from the 1999 – 2006 Medical Expenditure Panel Surveys, focusing on health care spending for adult naturalized citizens and immigrant noncitizens, including some undocumented immigrants. The results are summarized as follows:

[…] the cost of providing health care to immigrants is lower than that of providing care to U.S. natives, and immigrants are not contributing disproportionately to high health care costs in public programs such as Medicaid. However, noncitizen immigrants were found to be more likely than U.S. natives to have a health care visit classified as uncompensated care.

The impacts of this analysis in terms of both immigration reform and health care reform are clear. Questions about how the concerns of immigrants, especially noncitizens, would be addressed under a new system went largely overlooked during the 2009 discussions about health care reform. Researchers at Project HOPE explain:

The Personal Responsibility and Work Opportunity Reconciliation Act blocked immigrants’ access to much public health insurance coverage, which we suspect is partly responsible for the high level of uncompensated and charity care being provided to noncitizens.

Evidently, the noncitizen and recent immigrant communities have been offered few alternatives to secure first-rate, affordable health care, and methods for recourse are onerous at best. According to K. Tom Xu and Tommie W. Farrell at Health Services Research, obstacles to health care in the U.S. may precede “substitution of complementary and alternative care” outside of the official U.S. medical care framework, or return migration to one’s nation of origin to pursue medical care.

This is problematic because the lack of coverage for immigrant populations is largely based on the now-questionable assumption that their health coverage is more of a burden to the average taxpayer than the coverage of naturalized citizens. The researchers at Project HOPE therefore call for more study to determine how changes to national immigration policy will shape public health care programs. Potential federal and state health insurance proposals should weigh the data submitted in this and other current research that illustrate that the cost of supplying care to U.S. immigrants is lower than that of treating U.S. natives.

Ultimately, policy initiatives should be based on accurate evidence and must challenge assumptions about health care spending for immigrant populations.

By Nicole Cata, Policy Intern