By dramatically increasing the size of the uninsured population, immigration strains the resources of health care providers who offer services to the uninsured, making it much more difficult for them to help those without health insurance already here.
The Baltimore Sun, August 22, 2000
Among the most troubling social trends in recent years is the rapid increase in the number of people without health care insurance.
Both presidential candidates have proposed major new initiatives costing billions of dollars a year to deal with this growing problem. But neither candidate nor the public discourse on the issue has addressed a key underlying cause of the problem - immigration policy. New research indicates that, without a change in immigration policy, it will be nearly impossible to reduce the size of the uninsured population.
In a new study published by the Center for Immigration Studies, we found that new immigrants accounted for an astonishing 59 percent of the growth in size of the uninsured population between 1993 and 1998.
The study, based on analysis of Census Bureau data, also found that the nation's total uninsured population was one-third larger (32.7 million versus 44.3 million) when the 11.6 million people in immigrant families without insurance are counted.
This is an enormous effect because immigrant families account for only 13 percent of the nation's entire population. Government projections indicate that, absent a change in policy, 11 million immigrants will enter the country in just the next 10 years. If current trends continue, immigration will add perhaps 5 million to the ranks of the uninsured over next the decade alone.
To see how difficult immigration makes reducing the size of the uninsured population, we need only look at the State Children's Health Insurance Program (SCHIP) created by Congress in 1997, at an annual cost of $4 billion. So far, about 1 million low-income children have been enrolled in the program. But in just the last few years, immigration has increased the number of uninsured children in the United States by 700,000, off-setting most of the gains made under SCHIP.
By dramatically increasing the size of the uninsured population, immigration strains the resources of health care providers who offer services to the uninsured, making it much more difficult for them to help those without health insurance already here. Moreover, Americans with insurance must pay higher premiums as health care providers pass along some of the costs of treating the uninsured to paying customers.
Taxpayers, too, are affected as federal, state, and local governments struggle to provide care to the growing ranks of the uninsured.
About one-third of immigrants and their young children have no insurance - nearly 2 1/2 times the rate for natives. The primary reason so many immigrant families are uninsured is that a large percentage of immigrants have very little education.
Although we hear a great deal about educated immigrants starting high-tech companies, in fact, nearly half of all immigrants and their children live in or near poverty. Because of the limited value of their labor in an economy that increasingly demands educated workers, many immigrants hold jobs that do not offer health insurance, and their low incomes make it very difficult for them to buy insurance on their own.
So many immigrants are unskilled because current legal immigration policy puts almost no emphasis on skills or ability to compete in the modern American economy. Instead, having a relative in the United States is the primary basis for admission.
As for illegal immigration, we found that only about one-fourth of the uninsured in immigrant families were in the country illegally. Surprisingly, we also found that immigrants and their kids are about as likely to be uninsured today as when welfare reform passed in 1996. Moreover, immigrant families are still more likely to be on Medicaid - the nation's health insurance program for the poor linked to receipt of welfare.
Clearly, we are going to have to do something to provide insurance or at least basic care to the millions of uninsured immigrant families already here. But, if we are ever to get a handle on the nation's health insurance crisis, we will have to decide whether it makes sense to continue to allow hundreds of thousands of unskilled legal and illegal immigrants into the country each year. This cheap labor has a very high cost, and one of those costs is a much larger uninsured population.