Medical Expenditures on and by Immigrant Populations in the United States: A Systematic Review

Abstract

In health care policy debates, discussion centers around the often-misperceived costs of providing medical care to immigrants. This review seeks to compare health care expenditures of U.S. immigrants to those of U.S.-born individuals and evaluate the role which immigrants play in the rising cost of health care. We systematically examined all post-2000, peer-reviewed studies in PubMed related to health care expenditures by immigrants written in English in the United States. The reviewers extracted data independently using a standardized approach. Immigrants' overall expenditures were one-half to two-thirds those of U.S.-born individuals, across all assessed age groups, regardless of immigration status. Per capita expenditures from private and public insurance sources were lower for immigrants, particularly expenditures for undocumented immigrants. Immigrant individuals made larger out-of-pocket health care payments compared to U.S.-born individuals. Overall, immigrants almost certainly paid more toward medical expenses than they withdrew, providing a low-risk pool that subsidized the public and private health insurance markets. We conclude that insurance and medical care should be made more available to immigrants rather than less so.

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“…Otro criterio que ha determinado el grado de otorgamiento de derechos sociales a los migrantes es el uso de recursos públicos que, de entrada, se advierten escasos. Este argumento sigue siendo utilizado con tintes más políticos que económicos tanto en Estados Unidos como en México para afirmar que la población migrante implica un costo para el erario público a pesar de que la evidencia científica lo desmienta (Flavin, Zallman, McCormick y Boyd, 2018;Portery y Campos, 2017). Usando el argumento de la contención del gasto público, el diseño de políticas fomenta la estratificación de grupos de migrantes que tienen permitido disfrutar de manera diferenciada del acceso a derechos sociales (Caicedo, 2018).…”