Washington D.C. – As the current debate on health care rages in town halls across the nation, immigration is being used as a way to jam a stick into the wheels of impending reform. Some are scapegoating immigrants as a way to thwart progress on the issue and are arguing that even legal immigrants be restricted from our health system. Linking these two issues does nothing to advance necessary reforms to either health care or immigration.   The U.S. can do both, but public debate and discussion must be based on facts, not myths and misinformation. 

The U.S. is not spending “too much” on health care for immigrants.

– A July 2009 article in the American Journal of Public Health found that insured immigrants had much lower medical expenses than insured U.S.-born citizens.  Insured immigrants’ per-person medical expenditures were 1/2 to 2/3 less than the U.S.-born with similar characteristics. 
Recent immigrants constituted 5% of the nonelderly adult population, but were responsible for 2% of adults’ total health care costs, making their share disproportionately low.
– The vast majority of people in America who don’t have health insurance are U.S. citizens. 
– The majority of people who do not have insurance are U.S. citizens.  Noncitizens comprise a relatively small portion of the uninsured population.  Four out of five people in America who have no insurance are U.S. citizens.  U.S. citizens make up the majority of the uninsured (78%), while legal and undocumented immigrants account for 22% of the nonelderly uninsured. 

– Furthermore, U.S. citizens account for most of the growth in the number of uninsured individuals between 2000 and 2006. Citizens made up approximately 80% of the growth in the number of uninsured persons in America, while noncitizens accounted for approximately 20% of the growth.  

– The UCLA Center for Health Policy Research found that in 2005 undocumented immigrants made up only a small share of California’s uninsured population.  Nearly four in five of California’s uninsured adults and children were citizens and legal immigrants. 
Contrary to popular belief, noncitizens are significantly less likely to use emergency room services than U.S. citizens. 

– According to the non-partisan Kaiser Commission, noncitizens have poorer access to care and receive less primary health care than citizens, but they are less likely than citizens to use the emergency room.  In 2006, 20% of U.S.-citizen adults and 22% of U.S.-citizen children had visited the emergency room within the past year.  In contrast, 13% of noncitizen adults and 12% of noncitizen children had used emergency room care.  Despite the myths, immigrants use less health care, including less emergency room care, compared to U.S. citizens.

– A 2006 study published in Health Affairs found that communities with high rates of emergency room usage tend to have relatively small noncitizen populations.  Cities with large immigrant populations such as Miami-Dade County, Florida and Phoenix, Arizona have much lower rates of emergency room use than areas with small immigrant populations such as Cleveland.

For more information on immigrants and health care, see:

IPC Fact Sheet: Sharing the Costs, Sharing the Benefits: Inclusion is the Best Medicine

IPC Blog Post: Including Immigrants in Health Care Reform Makes Economic Sense

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