At a Capitol Hill briefing on July 18, 2000, the Center for Immigration Studies (CIS) released a report entitled "Without Coverage: Immigration's Impact on the Size and Growth of the Population Lacking Health Insurance."[1] The principal conclusion of the report is that "while other factors have contributed to the problem, immigration has had an enormous impact on the size and growth of the uninsured population in the United States." Noticeably absent from both the report and briefing was a systematic analysis of the economic factors responsible for the health insurance crisis among people of all backgrounds in the U.S., irrespective of immigration status.

Using data from the Census Bureau's March 1999 Current Population Survey, the report presents myriad statistics on the role played by immigration in allegedly increasing the ranks of the uninsured. One such statistic purported to show that in 1998 immigrants and their families accounted for 26.1% of the uninsured in the U.S., although they comprised 13.1% of the population. As a result, the total uninsured population is larger when the 11.6 million persons in immigrant households without insurance are counted. The report recognizes, but never explores, the underlying economic cause of this disparity: "many immigrants hold jobs that do not offer health insurance, and their comparatively low incomes make it very difficult for them to purchase insurance on their own."

Immigration Status Not A Factor

As this comment suggests, and given that 74% of the uninsured are not foreign-born, poverty and the nature of low-wage employment are more likely reasons for the lack of health insurance than is the uninsured's immigration status. A study released by The Commonwealth Fund found that "nine of the 11 million uninsured Hispanics are in working families" and "lack health insurance because their employers fail to offer them coverage".[2]

During the briefing, the study's authors were asked how the number of uninsured persons would be reduced if "native" workers were simply substituted for foreign-born workers in the same low-wage jobs that offer no health insurance. The authors responded with the suggestion that reducing the number of low-wage foreign-born workers would, by reducing the number of low-wage workers in general, facilitate the replacement of low-wage occupations with "capital" and "imports from abroad."

Immigrants' comparatively low incomes make it very difficult for them to purchase insurance on their own...

While a reduction in low-wage jobs might mean that more of the remaining positions had health insurance benefits, one must consider the ultimate impact this would have on the American economy. Yes, more of the employed might have health insurance, but the American economy would have less jobs. A central premise of the report is that "by increasing the size of the uninsured population, immigration makes it much more difficult to help the uninsured already here." Specifically, the report contends that the added burden of caring for uninsured foreign-born individuals and their families results in higher premiums for those who do have health insurance and drains the healthcare budgets of federal, state, and local governments that must provide medical care to the uninsured. However, the report makes no attempt to quantify how much uninsured immigrants presumably "cost" in either of these regards.

Immigrants Pay Their Share of Costs

The assumption underlying this argument is that the cost of providing healthcare to uninsured immigrants and their families, whatever that might be, exceeds any compensatory economic contributions they make. As a result, the report either distorts or ignores the growing body of data that quantifies these contributions by immigrants. For instance, the report claims that immigrant households participating in the Medicaid program are having insurance "provided to them at taxpayer expense," a comment which overlooks the fact that immigrants themselves are taxpayers.

Immigrant households and businesses generate approximately $162 billion per year in tax revenue to federal, state, and local governments -- Hardly a drain on the nation's economy!

The CIS report also overlooks a 1998 study by the National Immigration Forum and the Cato Institute which found that immigrant households and businesses generate approximately $162 billion per year in tax revenue to federal, state, and local governments. The same study estimates that, given the younger age profile of immigrants relative to the native-born, "the total net benefit (taxes paid over benefits received) to the Social Security system in today's dollars from continuing current levels of immigration is nearly $500 billion for the 1998-2022 period."[3] Conclusion Given the limited focus of the CIS report, its policy prescriptions consist entirely of restrictionist immigration measures: eliminating visa preferences for the spouses and minor children of non-citizens, and for the siblings, parents, and adult children of both naturalized citizens and legal permanent residents. During the briefing, former Colorado Governor Richard Lamm called for cracking down on the "stream of immi-grants from Central America and elsewhere" who come to the U.S. for surgery, while Georgia Congressman Charlie Norwood suggested enactment of a mandatory health insurance law modeled on mandatory requirements for auto insurance. However, none of these policies address the root causes of the health insurance crisis for either immigrants or nonimmigrants, and they avoid any mention of the enormous economic contributions made by immigrants.

The American Immigration Law Foundation was established in 1987 as a tax-exempt, not-for-profit educational and service organization. The Foundation's mission is to promote understanding among the general public of immigration law and policy, through education, policy analysis, and support to litigators. AILF is governed by a Board of Directors and a Board of Trustees.