American taxpayers give $17 billion a year on medical care of illegal immigrants

In total Americans pay for health care for illegals in the amount of $17 billion a year. In 2019 the Federal taxpayers had subsidized assistance in the amount of $10 billion. the Total is $615 per 1 illegal immigrant, and that means that every US resident pays $51. This writes Forbes.

Американские налогоплательщики отдают $17 млрд в год на медобслуживание нелегалов

Photo: Depositphotos

Current U.S. policy seeks to prohibit Federal tax funding of health care of illegal immigrants through Medicaid or Obamacare. In 2016, Americans paid $18.5 billion for medical services for illegal immigrants.

However, it is estimated that 4.1 million unauthorized immigrants in the country is likely to receive about $4.1 billion for medical services, paid for by Federal taxes, $2.4 billion for medical services funded by state and local taxpayers, and another $2.6 billion, which was financed by “redistribution of costs”, that is, higher payments to insured patients and about $1.3 billion from charity.

In some cases, the use of Federal money for funding medical care of illegal immigrants is strictly prohibited

Medicaid. Under Medicaid and CHIP (health insurance for children) no Federal funding can not be used to cover medical care for illegal immigrants, except for payment of limited emergency services. In particular, the “Medicaid payments for emergency services may be made on behalf of individuals who are eligible for Medicaid but do not have immigration status. These payments cover the cost of emergency care for lawfully present immigrants who are still not eligible for Medicaid, but also for illegal immigrants”.

For example, the California law “Health for all children” provides children with immigrant access to insurance through medical, the state Medicaid program. Its adoption in 2015, California became the largest state, which used the funding to cover medical services for all children, regardless of their immigration status.

ACA. In accordance with the ACA, immigrants must have the legal right to remain in the U.S. to purchase insurance under a qualified health plan or qualify for advance payment for premium tax credit or cost reduction.

In accordance with the legislation, signed by Governor Jerry brown in June 2016, California would be the first state that allowed undocumented immigrants to purchase health insurance plans through its insurance exchange, without fear that their information will be transferred to other government agencies.

This law involves changing the original terms of the ACA, which prohibits the participation of illegal immigrants in regular programs.

Where the use of Federal money to Fund medical services for illegal immigrants is allowed in an indirect way

A clear statement of the limitations inherent in Medicaid and Obamacare, you can work around a few workarounds that allow you to indirectly Fund health care for illegal immigrants from the budget.

Medicaid DSH Payments. The DSH program is simply provides the total subsidy against total losses uncompensated care from uninsured patients. Nothing requires that the hospital refused their spending on free services to illegal immigrants, and therefore, Federal Medicaid funds end up indirectly subsidizing their service even if it was clearly illegal to pay for their services, making them direct beneficiaries of Medicaid.

Medicare DSH Payments. Similarly, although the formula is much more complicated, Medicare also pays hospitals a DSH payment, which is actually serves as a total subsidy to compensate for the cumulative losses uncompensated care, making no distinction between uncompensated costs caused by illegal immigrants and those that generate us citizens or legal immigrants.

Public health centres. Federal qualified health centers provide primary care services, dentists, psychiatrists and pharmacies. They serve all comers, regardless of immigration status or ability to pay for care.

Exemption from taxes. Nonprofit hospitals (and other hospitals) annually receive tens of billions of dollars in benefits Federal tax, including charitable contributions and the cost of tax-exempt bond financing. Illegal immigrants benefit from this Federal generosity.

Tax from the employer. Tax employer provides an indirect Federal tax subsidies to everyone with employer-sponsored health insurance. Immigrants who are not citizens, are less likely to have coverage than natives, but the difference is less than 10 percentage points.

Current funding healthcare to illegal immigrants

The uninsured are illegal immigrants. According to the Pew Research center, in the United States in 2017 were 10.5 million illegal immigrants.

Currently, 14.9 percent of uninsured adults (4.1 million) are illegal immigrants who are not eligible to receive Medicaid and ACA in accordance with Federal law. About 70% of the cost of caring for illegals in the US are not kompensiruet, this means that in the end this one way or another paid by the society.

In 2013 (latest available data) the uninsured has created $to 84.9 billion in uncompensated care costs or $1 257 per person:

  • 39% was covered by various Federal programs;
  • 23% from state governments and local authorities (for example, through the support of taxpayers in state and local hospitals);
  • 12% came in the form of charitable assistance;
  • 25% was covered with hospitals. Unknown part of this stems from EMTALA, a Law on emergency assistance and active labor — the Federal law that requires hospitals to treat emergency patients regardless of ability to pay.

In the period from 2013 to 2018, the average daily level of uninsured decreased by 35% (according to the National survey on health, the level fell from 14.4% to 9.4%). It can be assumed that the level of uncompensated care will decline in direct proportion. However, according to the American hospital Association, free medical care in hospitals decreased by only 18% in the period from 2013 to 2017, although the average percentage of uninsured during the same period decreased by 37%.

In the period from 2013 to 2019, the spending for uncompensated care dropped by 16.9%, which is about $10.5 billion in uncompensated costs for care in 2019, funded as follows:

  • Us $4.1 billion in the Federal taxpayers;
  • $2.4 billion state and local taxpayers;
  • $2.6 billion for a hospital charity / bad debts may reallocated for the costs of private patients;
  • $1.3 billion in charity care;

The Federal taxpayers. A large part of the Federal funding comes indirectly through various Federal programs which Finance companies rather than individuals. these include hospitals (payment of Medicaid / Medicare DSH) and community health centers and free clinics.

Hospital charity care/bad debt. There is a clearer distinction between genuine charity and bad debt than in the past, when hospitals were very diverse methods of distinguishing between situations where the patient had to pay (charity care), and was not able to pay (bad debt).

Американские налогоплательщики отдают $17 млрд в год на медобслуживание нелегалов

Photo: Depositphotos

There is only limited evidence that hospitals participating in the so-called “dynamic redistribution of costs”. That is, if the burden of unpaid care hospital will increase by $ 1 million, we can expect that only part and not all of this amount will be recovered through increased costs of hospital private insured patients to compensate for the difference.

However, hospitals can and do exercise market power, and this means that they can charge private patients higher rate than patients with Medicare or Medicaid. This practice leads to a profit from private patients, which are then used by the hospital in various ways, including the provision of charity care.

The fact is that if the Federal government cancelled all the payments, which it now does for uncompensated care (including by illegal immigrants), hospitals hypothetically would not increase the cost of service for reimbursement of their increased costs for unpaid caregivers, and instead made adjustments and either have less to spend on other things, or taken steps to discourage illegal immigrants appear at their doors.

Charity. $ 1.3 billion for charitable assistance to doctors is estimated to average 1 $ 414 for each of the 893 000 active physicians in the nation. According to the Report on compensation for physicians Medscape for 2017, the average doctor earns $294 000 per year. Even if we take the 60-hour working week, which is about $ 100 per hour, which means that the average physician devotes 14.1 hours a year on charitable assistance to illegal immigrants.

Other Federal subsidies in favor of illegal immigrants

Current tax policy provides an additional $6.4 billion in the form of additional benefits funded by US taxpayers. Exemption from tax for nonprofit hospitals (and any other non-profit medical institutions) benefits to illegal immigrants, regardless of their insurance status. Tax incentives for employers are available to immigrants who receive employer-provided medical benefits.

Exemption from taxes. The cost of the tax exemption of nonprofit hospitals in the U.S. in 2019 amounted to approximately $28.7 billion, including donations and cost of tax-exempt bond financing. Assuming that 10.5 million illegal immigrants receive a proportionate share of the benefits, they receive approximately $0.9 billion in additional Federal subsidies for health care.

Tax from the employer. Estimating the size of these tax benefits for unauthorized immigrants is desperately needed. Almost half (48%) of unauthorized immigrants live in families with low income below 200% of the Federal poverty level.

However, only 4.1 million of the 10.5 million illegal immigrants are uninsured, resulting in 6.4 million have some coverage. Assuming that 91% have insurance coverage provided by the employer (which is identical to the percentage among all elderly with private insurance coverage in 2018), this equates to 5.8 million illegal immigrants with such a coating.

And even if we assume that these workers get less costly insurance coverage from the employer, the uniform payment in 2019 amounted to $6 189 (compared to $7,188 in other industries).


If you add up all the numbers, including $10.5 billion for uninsured individuals and another $6.5 billion in tax subsidies, we get a total amount of $17,0 billion in the form of subsidized health care for all illegal immigrants in 2019. These numbers are much easier to understand per capita:

  • it is allowance in the amount of $1615 for each illegal alien;
  • this imposes a burden of $51 for each inhabitant of the United States.