Immigrant adults represent a diverse group, accounting for 16% of the adult population in the United States. They play a vital role in the workforce and communities. As the 2024 election approaches, anti-immigrant rhetoric has intensified, making immigration a central topic for political candidates. The Trump campaign has labeled immigrants as sources of crime and burdens on taxpayers and government programs like Medicare and Social Security. In contrast, the Harris campaign emphasizes a tough-on-crime stance while also acknowledging her family’s immigrant background. Some states have implemented restrictive measures, including requiring hospitals to document patients’ immigration status.
In light of this rhetoric, understanding immigrants’ healthcare usage, costs, and their economic contributions is crucial. This report draws on data from the KFF/LA Times Survey of Immigrants, the largest national survey of immigrants to date, along with other research.
Government Assistance Usage
Despite facing lower household incomes and financial challenges, immigrant adults are no more likely than U.S.-born citizens to report using government assistance for food, housing, or healthcare. According to the 2023 KFF/LA Times Survey, approximately 28% of both immigrant and U.S.-born adults indicated they received such assistance in the past year.
Lawfully present immigrants often face restrictions for federal programs, including Medicaid and the Children’s Health Insurance Program (CHIP). Generally, they need a “qualified status” to access these programs. Most lawful permanent residents must wait five years after gaining qualified status before enrolling, although some, like refugees, are exempt from this waiting period. Lawfully present immigrants can purchase Affordable Care Act (ACA) Marketplace coverage without the five-year wait and can qualify for Medicare if they have sufficient work history.
Undocumented Immigrants
Undocumented immigrants cannot enroll in federally funded programs like Medicaid, CHIP, or Medicare, nor can they purchase coverage through the ACA Marketplaces. Some states have created fully state-funded programs to provide coverage for immigrants, though these vary in eligibility and benefits. Research indicates that expanding health coverage for immigrants can reduce uninsurance rates and improve health outcomes.
Healthcare Usage Among Immigrants
Studies show that immigrants, particularly undocumented ones, utilize less healthcare than U.S.-born individuals. The KFF/LA Times Survey found that only 63% of likely undocumented immigrants reported a healthcare visit in the past year, compared to 74% of lawfully present immigrants and 82% of naturalized citizens. This lower usage likely stems from immigrants being younger and healthier on average, combined with barriers like language challenges and fear of deportation.
Healthcare Costs
Due to their lower healthcare utilization, immigrants also have lower healthcare costs compared to U.S.-born citizens. KFF analysis of 2021 data revealed that annual per capita healthcare expenditures for immigrants average about $4,875, roughly two-thirds of the $7,277 spent by U.S.-born individuals. This trend holds across various types of healthcare, and studies show that immigrants generally incur lower healthcare expenditures than their U.S.-born counterparts.
Economic Contributions
Immigrants play a significant role in the U.S. economy, filling crucial labor market gaps and contributing to tax revenues. They do not take jobs away from U.S.-born citizens; instead, they often occupy essential positions in sectors like construction and agriculture. Immigrants and their children also make up a significant portion of the healthcare workforce, which is particularly important as shortages in this field are expected to grow.
Analysis reveals that undocumented immigrants contribute billions in federal, state, and local taxes each year, with a substantial portion going to payroll taxes that fund programs they cannot access, like Social Security and Medicare. Research suggests that without these contributions, the Medicare Trust Fund would face insolvency sooner, and undocumented immigrants positively impact the financial status of Social Security.
Conclusion
As the immigration debate intensifies in the lead-up to the 2024 election, understanding the contributions and challenges faced by immigrant adults is essential. They play a critical role in the U.S. workforce and economy while navigating significant barriers in accessing healthcare and government assistance.
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