KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Health Care Overhaul Ignores Illegal Immigrants

"As Congress wrangles with overhauling the health care system, there is one population not being discussed. No proposal for a national health plan would cover the nation's estimated 11 million illegal immigrants," NPR reports. But "analysts say the notion that illegal immigrants drain the health system is overblown. Simply figuring out how many undocumented immigrants lack insurance is not easy," although the Lewin Group has estimated that the number is about 6.1 million, which is "only about half the total population of undocumented immigrants." John Sheils of the Lewin Group "says many illegal immigrants use false documents to work on the books, with regular tax deductions and benefits."

Paul Fronstin of the Employee Benefit Research Group "says illegal immigrants are younger, and so generally healthier, than the overall population, and studies show they go to the doctor far less than the native born. He estimates their total share of the health care system at about 1 or 2 percent, with only a small slice of that paid for in public money. About $1 billion a year is paid by Emergency Medicaid, a federal program that covers emergency care for patients who would otherwise be eligible for Medicaid but can't prove their legal status. Sheils estimates that an additional $5 billion is uncompensated in any way. He says that's a blip on the national health care system - some two-tenths of 1 percent - but it can hurt when it falls disproportionately on hospitals, say, along the southern U.S. border."

Carla Luggiero of the American Hospital Association "has seen more and more hospitals face the burden of caring for illegal immigrants in the past decade. Some have had to raise fees. Others qualify for extra federal subsidies if they have an especially large number of Medicare or Medicaid patients. Luggiero says this can be a way to indirectly cover part of the cost of caring for the undocumented. … Luggiero says if Congress does not include illegal immigrants in any health plan, hospitals will look for those federal payments to continue. They would also like lawmakers to revive a separate subsidy that reimbursed hospitals several hundred million dollars for care of the undocumented in recent years but has expired" (Ludden, 7/8).

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