Advocates for Evidence-Based Health Policy Speakers
The Impact of Immigrants is Positive
The effect immigrant communities have, as recipients versus contributors, to social services in the United States is a topic commonly used as a political foil. Recent literature shows that the economic impact of immigrants is positive, acting as net contributors to federal institutions such as Medicaid and Medicare. The application of empirical methods to our immigration debate will reshape how we value immigrant communities and help develop future policies that support a healthy American society.
Economic migrants, due to their relative health and lack of access to public services, pay more out of pocket than the average U.S. citizen. Immigrants of all statuses had less than half the Medicaid expenditures as compared to U.S. citizens. This trend is amplified within non-citizen immigrants. In addition, contrary to popular belief, immigrants are net contributors to the Medicare trust fund.
Policy debates often frame immigrants through their costs on our legal, health care, and educational systems. Though immigrants do not benefit from all the same publicly funded programs as citizens, many pay state and federal income tax; all pay sales tax through their daily activities. These contributions far exceed the public medical expenditures by over $14 billion.
Recent immigrants are net contributors to federal healthcare safety networks for several reasons. Individuals who survive what can be a long and perilous journey are often the most motivated and able-bodied. Once in the US, immigrants are less likely to access resources than native-born citizens due to language and cultural barriers. Even legal immigrants may be denied services. For example, legislative language in the Affordable Care Act placed a 5-year waiting period for individuals granted citizenship prior to accessing health insurance through the ACA exchanges.
The contribution immigrant communities have made to the United States can be measured in great works of art, research, and social advancement. Immigration for economic reasons, however, is especially beneficial in an open, capitalist society, where the free flow of human and financial resources benefits all parties. Data on immigrants continues to outline the positive aspects they play in American culture. The success of future legislative action will depend on our ability to ground policy discourse in an evidence-based understanding of these economic and social trends.
Abstract
In health care policy debates, discussion centers around the often-misperceived costs of providing medical care to immigrants. This review seeks to compare health care expenditures of U.S. immigrants to those of U.S.-born individuals and evaluate the role which immigrants play in the rising cost of health care. We systematically examined all post-2000, peer-reviewed studies in PubMed related to health care expenditures by immigrants written in English in the United States. The reviewers extracted data independently using a standardized approach. Immigrants’ overall expenditures were one-half to two-thirds those of U.S.-born individuals, across all assessed age groups, regardless of immigration status. Per capita expenditures from private and public insurance sources were lower for immigrants, particularly expenditures for undocumented immigrants. Immigrant individuals made larger out-of-pocket health care payments compared to U.S.-born individuals. Overall, immigrants almost certainly paid more toward medical expenses than they withdrew, providing a low-risk pool that subsidized the public and private health insurance markets. We conclude that insurance and medical care should be made more available to immigrants rather than less so.
PMID: 30088434
You must be logged in to post a comment.