Health Care for Undocumented Immigrants Cost $1.1B in 2000, Study Finds

Health care for undocumented immigrants between ages 18 and 64 cost the U.S. $1.1 billion in 2000, or about $11 per taxpayer household, according to a study by RAND published Tuesday in the journal Health Affairs, the Los Angeles Times reports. For the study, researchers used data from a 2000 survey of 2,543 adults in 65 Los Angeles County neighborhoods. Children and seniors were excluded from the study. The survey asked participants about their use of hospitals and clinics over the past two years. Participants also were asked a number of questions about their legal status and whether they were authorized the stay in the U.S., as well as questions to determine the extent of a neighborhood's impact on people's lives. Researchers inflated the cost of services by 25% to account for incidental costs, according to study author and RAND economist Jim Smith. Researchers found that 22% of undocumented immigrants have health insurance, which covered about $362 million in costs in 2000. Immigrants paid $321 million of health care costs out-of-pocket. The study also found that undocumented immigrants tend to visit physicians less frequently than U.S. citizens because they are younger and because people with chronic health problems are less likely to cross the border, according to Smith. Researchers also found that 40% of male undocumented immigrants had never received a medical checkup and that 23% had never seen physicians, compared with 21% and 10% of male U.S. citizens, respectively. About 21% of undocumented female immigrants had never received a checkup, compared with 5% of female U.S. citizens, according to the study.

Comments
The Federation for American Immigration Reform said the study underestimated the cost of health care for undocumented immigrants. The federation estimated the cost of undocumented immigrants' health care in California alone is about $1.4 billion. Jack Martin of the federation said, "From the studies that we have done, (the RAND study) certainly is a low-ball estimate. But there are issues other than cost. ... In the emergency rooms, it has to do with very finite resources and the fact that those medical facilities end up at times being severely overburdened so that the quality of attention that they can give to U.S. citizens and legal permanent residents is degraded." Smith acknowledged the limitations of the 2000 survey, but said, "Let's say I'm wrong and I've understated these costs by $1 billion -- which is a lot -- I'd still conclude the same thing: that these are relatively small aggregate costs for the nation." Margaret Laws, director of public financing and policy for the California HealthCare Foundation, said, "Short of hospitals collecting and reporting data in a way they don't now, there is no other way to measure this. It is the best thing we have" (Larrubia, Los Angeles Times, 11/15).
The study is available online.