• Posted November 10, 2022

U.S. Immigrants' Premiums, Taxes Exceed Health Care Expenditures: Study

In a finding that challenges the notion that immigrants are freeloaders in the American health care system, a new study shows they are paying a lot more through health care premiums and related taxes than they actually use in care.

In fact, the amount that immigrants pay in makes up for some of the amount of health care that non-immigrants use in excess of what they pay.

"Some politicians and pundits tell Americans that immigrants are a burden to society, and particularly to our health care system,"senior study author Dr. Steffie Woolhandler, a distinguished professor at City University of New York's (CUNY) Hunter College and lecturer at Harvard Medical School, said in a CUNY news release.

"But the opposite is true. Immigrants subsidize the care of other Americans, to the tune of tens of billions of dollars each year,"she explained.

The study found that immigrants paid about $58.3 billion more in health insurance premiums and taxes than insurers and federal, state and local governments paid for their care in 2017. About 89% of immigrants' total surplus contributions were made by undocumented immigrants.

Conversely, Americans born in the United States received $67.2 billion more in care than they actually paid, according to the study authors.

To arrive at that unexpected finding, researchers analyzed detailed data from the Census Bureau's Current Population Survey, the American Community Survey, and the Medical Expenditure Panel Survey, calculating individuals' total payments into private and government insurers through premiums and taxes.

The study authors also included additional information on taxation and Medicaid spending in each state and nationally, and the costs of uncompensated or charity care provided by hospitals, based on an estimate from the American Hospital Association.

While the main analysis used data for 2017, which was the most recent year available for the government surveys, the study also provided cumulative estimates for 2012 to 2017.

Looking at that whole six-year period, immigrants' surplus contributions to the health system totaled $184.2 billion. By comparison, U.S.-born Americans received $185.2 billion more in care than they paid in.

Immigrants use less health care, the study authors reported. An average immigrant pays in $6,345 for care while receiving $5,061 in care. An average American born in the United States pays in $6,269, but receives $6,511 in care, the findings showed.

The surplus paid in by undocumented immigrants was especially large, at $4,418 per person, the study authors said. This may reflect their tendency to be young and healthy. Though they tend to contribute to the health financing system through employment-based taxes and insurance premiums, they are often reluctant to seek health care, the team concluded.

The findings were published online Nov. 9 in JAMA Network Open.

More information

KFF has more on Americans and health care costs.

SOURCE: City University of New York Hunter College, news release, Nov. 9, 2022