New Study: Immigrants Use Little Health Care, May Help Subsidize Care of Non-Immigrants

08/08/2018

CAMBRIDGE, Mass. – A study published today in the International Journal of Health Services finds that immigrants use far less health care than non-immigrants and may actually subsidize the care of citizens. The findings by researchers at Cambridge Health Alliance/Harvard Medical School and Tufts University School of Medicine contradict claims by President Trump and other political leaders that immigrants drive up U.S. medical costs.

Researchers conducted a comprehensive, systematic review of all studies published since 2000 comparing health care utilization of immigrants in the U.S. to those of persons born here. Compared to those born in the U.S., researchers found that immigrants had low utilization, as measured by health care expenditures by immigrants themselves, as well as costs paid by public programs and private insurers. Immigrants' utilization was only one-half to two-thirds as high as that of U.S.-born Americans, across all age groups.

Relative to U.S.-born persons, utilization was low for immigrants who had attained U.S. citizenship and documented non-citizens, but undocumented immigrants had by far the lowest utilization. Researchers also found that immigrants paid for a larger share of their care out-of-pocket compared to those born in the U.S.

The study concludes that immigrants may be subsidizing private insurance and some public insurance programs such as Medicare because they constitute a low-risk pool that pays more into the system (by way of premiums and tax contributions) than is paid out for their care.

"Recent immigrants are substantially healthier than native-born Americans, which not only benefits them but also the American health care economy," said study author Lila Flavin, a medical student at Tufts University School of Medicine. "But to maintain their health over the long term, new immigrants -- and all Americans -- need access to good health care. Denying care to immigrants is a human rights violation that cannot be justified based on costs, and indeed may raise costs in the future."

Flavin continued: "Immigrants have been blamed for a range of problems plaguing the U.S. including health care costs. But studies demonstrate that immigrants are propping up the Medicare Trust Fund by paying much more into Medicare than they will ever receive in benefits."

"Our findings also show that immigrants are clearly bringing down per capita health care costs and are likely subsidizing care for native-born Americans," said J. Wesley Boyd, MD, PhD, a psychiatrist at Cambridge Health Alliance and an associate professor of psychiatry at Harvard Medical School and Harvard's Center for Bioethics. "Instead of attacking immigrants for driving up costs, we should recognize their proven economic contributions."

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"Review of Medical Expenditures of Immigrant Populations in the United States." Lila Flavin, Leah Zallman, MD, MPH, Danny McCormick, MD, MPH, and J. Wesley Boyd, MD, PhD. International Journal of Health Services, August 8, 2018.