Commentary
The Financial Burden of Health Coverage of Undocumented Immigrants
A recent Kaiser Family Foundation policy sheet reported that in 2019 , there were 21.3 million non-citizens in the U . S ., representing approximately 7 % of the entire U . S . population . While the number of noncitizen residents who are in the U . S . illegally , so-called “ undocumented immigrants ,” is not precisely known , the U . S . Department of Homeland Security , the Pew Hispanic Center , the Center for Immigration Studies , and the U . S . Census Bureau have variously provided estimates ranging from approximately 10 to 12 million persons , acknowledging these may underestimate the actual number by as much as 10 %. In any case , these figures indicate that the undocumented immigrant population in the U . S . may range to nearly one-half of total non-citizen U . S . residents . In 2018 , an estimated 5 % of Arkansas residents were foreign-born . According to 2019 data from a
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The following commentary reflects the research and observation of the author .
Migration Policy Institute analysis of U . S . Census Bureau data , about 58,000 persons constituted the “ unauthorized population ” in Arkansas . The majority , 52 %, came from Mexico ; however , El Salvador , the Marshall Islands , and Guatemala were also top countries of origin . An estimated 36,000 persons , 63 %, were uninsured .
Illegal border crossing began to increase in late 2020 but skyrocketed after President Biden took office in January 2021 and changed border-enforcement policies . The Washington Post recently reported that in fiscal year 2021 , the Border Patrol made about 1.66 million arrests of migrants crossing the U . S . -Mexico border illegally , the highest annual number ever recorded . Mexico was the single largest source of illegal migration during the 2021 fiscal year , as the Border Patrol arrested more than 608,000 Mexican nationals . The next-largest arrest category is a grouping the CBP ( U . S . Border and Custom Protection ) categorized as “ other ,” including Haitians , Venezuelans , Ecuadorans , Cubans , Brazilians , and migrants from dozens of other nations ; these account for 367,000 arrests . These are followed by migrants from Honduras ( 309,000 ), Guatemala ( 279,000 ), and El Salvador ( 96,000 ). However , these figures do not include the unknown number of migrants who successfully evaded capture by the CBP . The CBP does not publish data of evasion estimates , but agency officials have reported averages of more than 1000 daily over the past several months . Of the 1.66 million arrests made during fiscal 2021 , 61 % were expelled under Title 42 , ( which prohibits entry into the U . S . by any person who may be in danger of bringing a communicable disease with them and has been implemented in response to the Covid-19 pandemic ). These expulsions have resulted in a marked increase in repeat border crossing attempts . In recent months the rates for recidivism have reached 38 % – more than double that of previous years .
A 2019 report by the Center for Immigration Studies estimated that nationally , there are about 4.9 million uninsured , undocumented immigrants who could qualify for subsidies under the Affordable Care Act ( ACA ). Considering the age and income of these individuals , it was by Darrell R . Over , MD , MSc ., FAAFP
estimated the average cost of providing an ACA subsidy for each person would be about $ 4,600 annually . Thus , the total cost of providing ACA subsidies to the undocumented American population , if all individuals enrolled , could be $ 22.6 billion annually . Assuming a more realistic enrollment rate , the annual cost would still be about $ 10.4 billion annually . A second report by the Center for Immigration Studies issued at the same time reported that the average legal immigrant family created $ 2,796 in Medicaid costs compared with $ 1,983 for the average native family and the costs are even higher ($ 4,411 ) for Hispanic immigrant families . These estimates pre-dated the current pandemic and the migrant surge at our southern border .
The cost for health care for the current wave of undocumented migrants according to recent Senate testimony by the Center for Immigration Studies indicates : “ Many of the new arrivals will receive medical care from publicly funded ‘ safety net services ’ for maternity , emergency , and pediatric care , and also through federally subsidized community health care centers that provide the full range of medical services to the uninsured ( regardless of immigration status ). Determining the cost is complicated , but it would likely come to more than $ 500 million per year just for the migrants that have arrived this year , based on disclosures from states that have identified these expenditures .” Considering health insurance prices are currently at record highs , it is certain to accelerate costs if undocumented immigrants are given access to government programs like Medicare and Medicaid . It is worth noting that many of the children of undocumented immigrants already receive coverage under Medicaid .
Our nation ’ s health care system has finite resources – a fact verified in responding to the recent Covid-19 pandemic . Despite passage of the Affordable Care Act in 2010 , health care costs have continued to escalate ; still , we have millions of Americans uninsured or under-insured . What will be the effect of adding hundreds of thousands of uninsured , undocumented immigrants to our already struggling health care system ?
150 • The Journal of the Arkansas Medical Society www . ArkMed . org