Saturday, September 19, 2020


Article Index

B. Undocumented Immigrants Drain Our Healthcare System

The General Accounting Office (GOA) published a report in May 2004 that focused on the correlation between undocumented immigrants and their impact on hospitals' uncompensated care costs. The GOA was not able to collect sufficient data because hospitals do not usually collect immigration status information from patients. The GOA found that:

The impact of undocumented aliens on hospitals' uncompensated care costs remains uncertain. Determining the number of undocumented aliens treated at a hospital is challenging because hospitals generally do not collect information on patients' immigration status and because undocumented aliens are reluctant to identify themselves.

This lack of information makes it difficult to determine the number of undocumented immigrants that are treated by hospitals. If hospitals question individuals in regards to their immigration status, they may face a civil rights violation. Title VI of the Civil Rights Act of 1964 provides: No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. The GOA found that the relationship between undocumented immigrants and hospitals' uncompensated care costs would continue to be difficult to determine unless more reliable information is available.

The RAND Corporation, a nonprofit organization that conducts research and analysis, conducted a study that measured undocumented immigrants' use of medical care in comparison to the rest of the population. This study found that undocumented immigrants use less medical care services than would be expected, in relation to their representation in the U.S. population. The RAND Corporation used the Los Angeles County 2000 survey that focused on adults between the ages 18-64. LA County was used because the distribution of types of immigrants is very similar to that of the United States as a whole. The survey report contains detailed information on immigrants' legal or visa status, health status, type and amount of health care used, and health insurance. The LA County study differs from the method used in the GAO's study because the LA County study surveyed the individuals in the sampling group, and the GOA surveyed the hospitals.

The RAND Corporation used statistics from the LA County survey and from the 2000 census. The study compared statistics between native-born individuals and foreign-born individuals. The foreign-born were then broken down into subcategories, which included: U.S. citizens, permanent residents, undocumented immigrants, and temporary legal immigrants. The RAND study found that undocumented immigrants are generally younger than the native-born and other immigrants. They are also healthier and less likely to suffer from chronic illnesses. The study also found that hospitalization rates were lower for foreign-born men and women as compared to the native-born. Only 11 percent of undocumented immigrants had been in the hospital within the two previous years, 58 percent had seen a doctor within the past year, 32 percent had never had a checkup, and 17 percent had never seen a doctor. The study found that hospital and doctors' visits were more common among both native-born and foreign-born women, probably due to pregnancy. But only 2 percent of the undocumented males had been hospitalized within the previous two years, 40 percent never had a check-up, and 23 percent had never seen a doctor. The RAND study found that the total national medical costs for the year 2000 was about $429 billion for those ages 1864. Of this total, $37 billion, or 8.5 percent, is attributed to the foreign-born population, and $6.5 billion or only 1.5 percent is attributed to undocumented immigrants.

The RAND Corporation translated these figures into taxes paid per household to finance medical care. In 2000, $89 billion was spent by the public sector to provide care for adults ages 18- 64. This cost the 105 million households in the U.S. $843 per household in 2000. However, only a total of $11 dollars was attributed to the cost associated with undocumented immigrants.

Vernellia R. Randall
Founder and Editor
Professor Emerita of Law
The University of Dayton School of Law