Immigrants in the U.S. Health Care System

Five Myths That Misinform the American Public

By Meredith King Ledford | June 7, 2007

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Restrictionist politicians and talking heads concur that immigrants in the United States are a burden on our health care system. A decade ago this belief contributed to legislation that limited immigrants’ access to the health care system. Today, similar sentiments misinform the current debate over immigration reform.

These myths about documented and undocumented immigrants’ use of U.S. health care services need to be examined in detail if our nation is going to have a true understanding about the immigrants in the U.S. health care system. The five most prevalent of these myths are:

• U.S. public health insurance programs are overburdened with documented and undocumented immigrants.
• Immigrants consume large quantities of limited health care resources.
• Immigrants come to the United States to gain access to health care services.
• Restricting immigrants’ access to the health care system will not affect American citizens.
• Undocumented immigrants are “free-riders” in the American health care system.

These misconceptions feed a perception that one of the biggest reasons for our nation’s failing health care system is the growth of immigration—and not the lack of insurance and skyrocketing health care costs. As a consequence, these myths have influenced policymaking and sparked federal efforts to preclude immigrants’ access to the health care system.

Such an effort culminated in the 1996 passage of the Personal Responsibility and Work Opportunity Reconciliation Act, which put a five-year ban on eligibility for Medicaid and other public benefits programs for recent immigrants. These same eligibility restrictions were also included in the State Children’s Health Insurance Program, which was enacted in 1997.

Then as part of the Deficit Reduction Act of 2005, the law now requires U.S. citizens to provide proof of citizenship when applying for Medicaid benefits, with the intention of preventing immigrants from obtaining Medicaid coverage.

As this paper will demonstrate, these myths perpetuate the marginal status of immigrants—for this paper, non-citizens—in the U.S. health care system and promote poor policymaking at all levels of government. These myths need to be subjected to the bright light of objective analysis to better inform critical policy making decisions on health care reform and immigration reform moving forward.

• Read the report (PDF)