Immigrants Actually Subsidize US Health Care, Rather than Bringing Diseases

There has been a huge deal made about the demographic characteristics of the "caravan" of immigrants heading through Mexico on their way from Central America to the United States, where they apparently hope to seek asylum. Fox News and the Trump administration have repeatedly suggested that they are bringing small pox and leprosy. This is clearly nonsense. The World Health Organization declared back in 1980 that small pox had been eradicated from the world (thank you, vaccinations!!). Leprosy is still with us, but almost all cases are concentrated in Africa and South Asia, so it is unlikely that anyone in this group heading north has been exposed to the disease. We can put those negative ideas to bed with regard to this group of migrants, or any other group of people coming into the U.S. (all of whom are, of course, subjected to medical exams in all events).

What about the positive aspects of immigrants? In my last post, I mentioned that the Baby Boomers are really going to need some young immigrant workers to help pay for their retirement. It also turns out that immigrants are a net economic benefit to the health care system in this country. Many thanks to Professor Rubén Rumbaut for a link to a blog post in AcademyHealth by a physician who is Director of Research at the Institute for Community Health in Massachusetts.

Published in the October edition of Health Affairs, findings from our study using nationally representative data show that immigrants heavily subsidize private insurance of US-born enrollees and boost profits of private insurers.

For many immigrants, such as undocumented immigrants or those residing legally in the US for fewer than five years, private insurance is often the only coverage option. Because immigrants are mostly working-age adults with high rates of labor force participation, many enroll in job-based coverage.

Our study was the first to look at immigrants' role in financing private health insurance. We used data from the Medical Expenditure Panel Survey and the Census Bureau’s Current Population Survey to determine immigrants' premium contributions to private insurance, including premiums that employers paid on their behalf. Then we tabulated all payments that private insurers made to doctors, hospitals, and other providers for immigrants' care to determine whether immigrants paid more or less into private insurance than they used. Undocumented immigrants, who generally use little medical care, generated the largest surplus at $1,445 per enrollee. The surplus contributed by immigrants offset a per enrollee deficit among US born individuals of $163. Previous research shows that insurance outlays for immigrants are low because they are relatively young and healthy, and often face linguistic and other barriers to care.

This is the "real" side of immigration. The U.S. is a nation of immigrants, and the only people who can realistically complain about that are Native Americans.