Commentary: Reality check: immigrants and their health care

Dr. Michele Waslin

Dr. Michele Waslin

By Dr. Michele Waslin
For Northwest Asian Weekly

As the current debate on health care rages in town halls across the nation, immigration is being used as a way to jam a stick into the wheels of impending reform.

Some are scapegoating immigrants as a way to thwart progress on the issue and are further arguing that legal immigrants should be restricted from our health care system.

Linking these two issues does nothing to advance necessary reforms to either health care or immigration.

The United States can do both, but public debate and discussion must be based on facts, not myths and misinformation.

The United States is not spending “too much” on health care for immigrants.

A July 2009 article in the American Journal of Public Health found that insured immigrants had much lower medical expenses than insured U.S.-born citizens. Insured immigrants’ per-person medical expenditures were one-half to two-thirds less than their U.S.-born counterparts with similar characteristics.

Recent immigrants constituted 5 percent of the nonelderly adult population but were responsible for 2 percent of adults’ total health care costs, making their share disproportionately low.

The vast majority of people in America who don’t have health insurance are U.S. citizens.

The majority of people who do not have insurance are U.S. citizens. Noncitizens comprise a relatively small portion of the uninsured population. Four out of five people in America who have no insurance are U.S. citizens.

U.S. citizens make up the majority of the uninsured (78 percent), while legal and undocumented immigrants account for 22 percent of the nonelderly uninsured.

Furthermore, U.S. citizens account for most of the growth in the number of uninsured individuals between 2000 and 2006.

Citizens made up approximately 80 percent of the growth in the number of the uninsured in the United States, while noncitizens accounted for approximately 20 percent of the growth.

The UCLA Center for Health Policy Research found that in 2005, undocumented immigrants made up only a small share of California’s uninsured population. Nearly four in five of California’s uninsured adults and children were citizens and legal immigrants.

Contrary to popular belief, noncitizens are significantly less likely to use emergency room services than U.S. citizens.

According to the non-partisan Kaiser Commission, noncitizens have poorer access to care and receive less primary health care than citizens.

However, they are still less likely than citizens to use the emergency room.  In 2006, 20 percent of U.S.-citizen adults and 22 percent of U.S.-citizen children visited an emergency room within the past year.

In contrast, 13 percent of noncitizen adults and 12 percent of noncitizen children used emergency room care. Despite the myths, immigrants use less health care, including emergency room care, compared to U.S. citizens. A 2006 study published in Health Affairs found that communities with high rates of emergency room usage tend to have relatively small noncitizen populations.

Cities with large immigrant populations, such as in Miami-Dade County, Fla., and Phoenix, have much lower rates of emergency room use than areas with small immigrant populations such as Cleveland. ♦

Michele Waslin, Ph.D., is the senior policy analyst at the Immigration Policy Center. She has authored several publications on immigration policy and post-9/11 immigration issues.

For more information about immigrants and health care, visit or

Waslin can be reached at

4 Responses to “Commentary: Reality check: immigrants and their health care”

  1. You actually make it seem really easy along with your presentation however I find this topic to be really something which I think I might never understand. It seems too complicated and very large for me. I am taking a look forward in your subsequent put up, I will attempt to get the hang of it!

  2. PAM says:

    My friend’s girlfriend is from the UK. She is pregnant with his child. She had to go to the emergency room last night. Bob…. are you saying that she, being a UK citizen and not a US citizen, is entitled to FREE US Healthcare?

  3. William Turnbull. says:

    Dr. Waslin says that …”immigration is being used as a way to jam a stick into the wheels of impending reform.” and that opponents are arguing that we spend too much on health care for immigrants.

    Once again, there is a difference between those here legally and those here illegally. I know of no one who is arguing that the United States is spending too much on health care for legal immigrants.

    The issue here is illegal immigrants. Illegal immigrants make up over nine million of the purported 45.6 million uninsured.

    According to “Income, Poverty, and Health Insurance Coverage in the United States,” a Census Bureau report published in August 2008, there were 45.6 million persons in the United States who did not have health insurance in 2007, the latest year for which figures are available. However, the report states that 9.7 million of these uninsured persons were not U.S. citizens.

    Dr. Waslin states that “Nearly four in five of California’s uninsured adults and children were citizens and legal immigrants.” That means that 20% of the uninsured were not citizens or legal immigrants, a figure which closely concurs with the Census Bureau figures of 9.7 million of 45.6 million!

    Now that we have fairly defined “immigrant” vs “illegal immigrant”, something Dr. Waslin conveniently did not do, we can consider who is and who is not a drain on the health system here.

    Visit an emergency room in any hospital and you will see where illegal immigrants get their medical care. This care, often for minor ailments, is billed by hospitals at grossly high Emergency Room rates, costing hospitals and tax payers many times what a normal clinic would charge. It is very unlikely that any of these visitors can or will ever pay for the care they are receiving. It is passed on to you and I in the form of higher taxes, insurance costs and medical bills.

    In addition, those here illegally do not undergo any health checks on entry. Any illness they may have is simply carried here to be charged to the American people in the form of higher rates of infection and higher medical bills, taxes and insurance rates to subsidize this practice.

    For the doctor to try to make an argument confusing the effects of illegal immigrants with those of legal immigrants is shamefully deceptive and fraudulent. It is time to get rid of the illegal immigrants who are definitely a drain on the system.

  4. Delaware Bob says:

    Illegal aliens already get get FREE healthcare. Imagine that. You are in this country ILLEGALLY and you get FREE health care, free schooling, public housing (obama’s aunt and others), food stamps and a host of other things…all from being in this country ILLEGALLY.

    Illegal aliens have made America the dumping ground for all their illegal alien children, then we have to school them and give them free medical care.

    I for one, am sick and tired of these ILLEGAL ALIENS snubbing their nose at our immigration laws and the many other laws of this Country. If our Federal Government can not ENFORCE our immigration laws, and get these ILLEGAL ALIENS out of this Country, then let the States do it! One way or another, an end has to come to this illegal immigration, and not with AMNESTY! Amnesty will only encourage more ILLEGAL ALIENS to invade our Country and reward those who broke our laws and raped the American taxpayer in many ways…depressing our wages, taking our jobs, overwhelming our schools with their ILLEGAL ALIEN children, driving without a license or car insurance, all the crime from stolen identities to rape, drugs and everything else.

    It’s time for ZERO TOLERENCE with these ILLEGAL ALIENS. It’s time for them get out of this Country and back in their own Country where they belong. When we get rid of all the illegal aliens, we will get rid of all the problems that go with them. THAT IS A FACT!


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