Uninsured Immigrants Burden the Health Care System

Published October 1, 2001

Managing Editor’s note: The increase in the number of people without health insurance is one of the our most troubling social trends. An under-reported study from the Center for Immigration Studies finds the nation’s health insurance crisis is being driven to a measurable degree by immigration policy.

The study, “Without Coverage: Immigration’s Impact on the Size and Growth of the Population Lacking Health Insurance,” was written by the Center’s director of research, Steven A. Camarota, and James R. Edwards Jr. of the Hudson Institute. It offers detailed information, based on Census Bureau data, on immigrant and native insurance coverage at the national level, as well as for the major immigrant-receiving states and cities.

In 1998, 32.4 percent of persons living in immigrant households (primarily Immigrants and their young children) lacked health insurance–more than twice the 13.9 percent of persons in native households.

Immigrants who arrived between 1994 and 1998 and their children accounted for an astonishing 59 percent of the growth in the size of the uninsured population–2.7 million people–since 1993.

The total uninsured population is one-third larger (44.3 million versus 32.7 million) when the 11.6 million persons in immigrant households without insurance are counted.

The debate over the growing number of uninsured in this country has failed to take into account the enormous impact of immigration on the nation’s health insurance crisis. We cannot hope to contain health care costs or reduce the number of uninsured in the U.S. without addressing the role of immigration policy.

A Difficult, Costly Problem

Immigration has made it much more difficult to reduce the size of the uninsured population. In just the last few years, for example, immigration has increased the number of uninsured children in the United States by more than 700,000, enough to offset most of the gains made so far under the new State Children’s Health Insurance Program, enacted by Congress in 1997 at a cost of $4 billion a year.

Lack of insurance remains a severe problem even after immigrants have been in the country for many years. In 1998, 37 percent of immigrants who entered in the 1980s still had not acquired health insurance, and 27.2 percent of 1970s’ immigrants were uninsured.

The lack of insurance is not solely a problem of illegal immigrants. Although a very high percentage do not have health insurance, illegal aliens comprise only an estimated 26.8 percent of the uninsured living in immigrant households.

The low rate of insurance coverage associated with immigrants is primarily explained by their lower levels of education and their higher poverty rates relative to natives. Because of the limited value of their labor in an economy that increasingly demands educated workers, many immigrants hold jobs that do not offer health insurance, and their low incomes make it very difficult for them to purchase insurance on their own.

The denial of benefits to some legal immigrants enacted as part of welfare reform in 1996 is not the reason so many persons in immigrant households are uninsured. Before welfare reform was enacted, nearly 31 percent of persons in immigrant households lacked health insurance, very similar to the current rate. Moreover, immigrant households continue to use Medicaid at higher rates than natives.

Policy Implications

By dramatically increasing the size of the uninsured population, immigration strains the resources of health care providers who provide services to the uninsured. Americans with insurance have to pay higher premiums as health care providers pass along some of the costs of treating the uninsured to paying customers. Taxpayers are also affected as federal, state, and local governments struggle to provide care to the growing ranks of the uninsured.

If current immigration policy remains in place, the Census Bureau estimates that 11 million new immigrants are likely to settle permanently in the United States in the next decade alone. The number of persons in immigrant households without health insurance could grow to 14 million.

If we are to deal effectively with the health insurance problem in this country, part of the solution must address immigration policy and expand access to health insurance to immigrants and their children already here.

For more information . . .

contact Steven A. Camarota, director of research for the Center for Immigration Studies, at 202/466-8185. The complete text of the study Camarota coauthored with James R. Edwards Jr. can be found on the Internet at http://www.cis.org/.