Health Care for Illegal Immigrants Could Cost Up to $23 Billion a Year: Report

October 14, 2019 Updated: October 15, 2019

WASHINGTON—During a June 27 Democratic debate, all 10 presidential candidates raised their hands when asked who among them would provide government-subsidized health care benefits to illegal immigrants.

The Washington-based think tank Center for Immigration Studies (CIS) has since crunched the numbers on the potential costs and released a report on Oct. 10.

Under current law, illegal aliens aren’t allowed to participate in the health insurance exchange established by the Affordable Care Act, also called Obamacare. They’re also not eligible for Medicaid; although all immigrants can receive emergency services, regardless of status. And U.S.-born children with illegal immigrant parents are eligible for all benefits.

CIS calculated its numbers based on an illegal population of about 10 million people, half of whom they estimate would be eligible for Obamacare subsidies or Medicaid.

“Now, you might say that’s surprising, but I think there’s a pretty high degree of consensus that very roughly half of illegal immigrants have health insurance,” said report author Steven Camarota, director of research for CIS. “Many either have higher incomes so they couldn’t get the subsidies or, for the most part, they are insured by employers.”

If all 5 million of those illegal immigrants signed up for Obamacare, it would cost an estimated $22.6 billion per year, Camarota said. But, he said, it’s more likely that just fewer than half of those would sign up, for an estimated cost of $10.4 billion annually.

“Now, another way to think about that is for every 1 million uninsured illegal immigrants who sign up for [Obamacare] and get the subsidy, the cost to taxpayers is about $4.6 billion,” Camarota said.

The report also estimated the cost based on an Obamacare/Medicaid hybrid approach. With 100 percent enrollment, it would cost about $19.6 billion per year, or $10.7 billion with about half-enrollment.

“One important caveat about these estimates is, we make no assumption about how giving free or subsidized health care to illegal immigrants might significantly increase the flow of new illegal immigrants into the country,” Camarota said. “If low-income people in other countries can come here free and get health care, it seems very likely that that could spur at least some additional illegal immigration.”

He said there would likely be a major push to give low-income guest workers and non-immigrant visa holders free or subsidized care. And the current five-year waiting period for green card holders could also be challenged.

“If we gave Medicaid to illegal immigrants …  legal immigrants certainly would have to get it, and that’s many millions of people,” he said.

illegal immigration
Steven Camarota, director of research for the Center for Immigration Studies, speaks at a panel discussion in Washington on Oct. 10, 2019. (Samira Bouaou/The Epoch Times)

Jason Richwine, a public-policy analyst based in Washington, said the two factors contributing most to being on Medicaid—for Americans and immigrants alike—are a low level of education and larger families. He said 42 percent of immigrant families had at least one member enrolled in Medicaid, compared to 26 percent of native families.

2020 Candidates

The 2020 Democratic candidates have shown an eagerness to provide not only government-subsidized health care to illegal immigrants, but also a pathway to citizenship.

Former Vice President and current Democrat frontrunner Joe Biden said on July 24, “Here’s the deal: We have 11 million undocumented people in the United States of America—I would provide a path to citizenship.”

Sen. Elizabeth Warren (D-Mass.) said she would expand legal immigration, decriminalize illegal border crossings, and provide amnesty to those here illegally.

“We need a pathway to citizenship for the people who are here and here to stay,” Warren said on Sept. 29. “We need a path, not just for DREAMers, but also a path for grandmas and for little kids and for people who came to work here on farms, and for students who overstayed their visas.”

Sen. Bernie Sanders (D-Vt.) says on his campaign website that he would also provide a pathway to citizenship for illegal aliens, as well as “dismantle cruel and inhumane deportation programs and detention centers.”

Taxpayer Burden

Health care has become the largest burden on taxpayers by a mile.

Chris Pope, a senior fellow in health policy for the Manhattan Institute, said Congressional Budget Office data shows that health care was 52 percent of means-tested federal programs in 2008.

“By 2028, it’s going to be 71 percent,” he said.

Prior to Obamacare, Pope said the Medicaid program was mainly used for low-income disabled people, low-income families, and sometimes as an elderly supplement to Medicare.

“Really for able-bodied working-age adults, the Medicaid program didn’t really do that much,” he said, aside from a few states that tangentially covered some people.

“The Affordable Care Act really changed that. The Affordable Care Act ensured that the Medicaid program was expanded to able-bodied, working-age adults … earning less than 138 percent of the federal poverty level—which is probably about $15,000 for an individual. And then, for a family it increases … so it could be $20,000,  30,000, $40,000, depending on household size.

“These days, when you’re talking about burdens on taxpayers, it’s really all about health care that we’re talking about.”

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