Academic journal article The Journal of Social, Political, and Economic Studies

Uncontrolled Immigration and the U.S. Health Care System

Academic journal article The Journal of Social, Political, and Economic Studies

Uncontrolled Immigration and the U.S. Health Care System

Article excerpt

The authors argue that the rising pressure of illegal and legal immigration into the United States is a major contributor to the current financial crisis that threatens the U.S. health care system. They produce evidence to show that in some hospitals, as much as two-thirds of total operating costs are for uncompensated care for illegal aliens, and that the massive volume of both legal and illegal immigration is responsible for an estimated national total of unreimbursed medical expenses that exceeds one billion dollars annually.

Key Words: American health care system; U.S. immigration; Illegal immigration; health insurance; Medicare; Medicaid.

America's health care system is in a state of crisis: Costs are sky-rocketing - 2003 saw the largest increase in health care costs in 13 years2 - placing an increasingly difficult burden on both individuals and businesses, while the number and proportion of uninsured persons is increasing. Large numbers of hospitals, especially those along the southwest border, have either cut back services, closed, or face bankruptcy largely caused by uncompensated care given to illegal immigrants. More than half of all counties surveyed by the National Association of Counties say that recent immigration - both legal and illegal - is causing their uncompensated health care costs to rise.3

As states cut their health care budgets to try to make ends meet, high rates of immigration, both legal and illegal, are causing a major drain on health care resources and taxpayer funds, but the failures of federal immigration enforcement tell only part of the story. In many areas, the magnitude and cost of illegal immigration are also consequences of local policies that encourage illegal alien settlement by granting costly benefits to people who violate immigration laws.

Under current U.S. law, hospitals must treat and stabilize anyone who seeks emergency care, regardless of income, insurance, or immigration status.4 Yet most hospitals receive little or no reimbursement for the care to legal and illegal immigrants that the federal government mandates that they provide. Although the Illegal Immigrant Reform and Immigrant Responsibility Act of 1996 (IIRAIRA) approved reimbursement to hospitals for emergency care for illegal immigrants, neither program has been funded.5

Lawsuits were brought by several states against the federal government in the 1990s, seeking reimbursement for the cost of handling the massive influx of illegal aliens that federal authorities had failed to contain, but these were dismissed on the grounds that the issue was a "political question" rather than a judicial issue.6

Medicaid and Medicare

The 1996 Personal Responsibility and Work Opportunity Reconciliation Act stopped immigrants from receiving Medicaid (which essentially seeks to provide mcdieal services for impoverished people who are below retirement age) for their first five years in the country (with exceptions for those who were already in the U.S. prior to 1996, children, and pregnant women). Medicaid funds are drawn from federal, state, and local budgets. Some 3.5 million immigrants were regularly enrolled in Medicaid in 2002, and an additional 3.7 million were enrolled in Medicare (which is primarily designed to provide medical services for older persons).7 Congress did not rule out emergency Medicaid, which allows both legal and illegal immigrants to receive emergency medical treatment.

U.S. Immigration Policies Responsible

U.S. immigration policies have played a significant role in creating the U.S. national health care crisis, in which more than 4L million Americans lack basic health insurance. Immigrants are two and a half times as likely to lack health insurance as U.S.-born citizens.8 One out of every four uninsured people in the United States is an immigrant, according to Census data, with immigrants currently comprising 11.5 percent of the total U.S. population. …

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