Health Bill Could Benefit 6.6 Million Illegals

As President Obama addresses the nation on health care reform, a new analysis by the Center for Immigration Studies estimates that 6.6 million uninsured illegal immigrants could receive benefits under the House health reform bill (H.R. 3200). While the bill states that illegal immigrants are not eligible for the new taxpayer-funded affordability credits, there is nothing in the bill to enforce this provision. Congress defeated efforts to require the use of the Systematic Alien Verification for Entitlements (SAVE) program. More than 70 other programs of this kind use SAVE.

The report is available at http://www.CIS.org/IllegalsAndHealthCareHR3200. Among the findings:

    --  In 2007, there were an estimated 6.6 million illegal immigrants without
        health insurance who had incomes below 400 percent of poverty, which is
        the income ceiling for the new affordability premium credits.

    --  If all uninsured illegal immigrants with incomes below 400 percent of
        poverty received the new credits, the estimated cost to the federal
        government would be $30.5 billion annually.

    --  The current cost of treating uninsured illegal immigrants at all levels
        of government is an estimated $4.3 billion a year, primarily at
        emergency rooms and free clinics.

    --  On July 16 an amendment by Rep. Dean Heller (R-NV) that would have
        required the use of the Systematic Alien Verification for Entitlements
        (SAVE) program to prevent illegal immigrants from receiving the
        affordability credits was defeated by the House Ways and Means
        Committee.

    --  At present 71 other means-tested federal programs require use of the
        SAVE system to prevent illegal immigrants and other ineligible
        non-citizens from accessing them.

    --  Even though there is no mechanism to prevent enrollment, it is likely
        that many income-eligible illegal immigrants would not enroll out of
        fear or lack of knowledge of the new programs. Thus the actual costs
        would be less than the maximum estimate of $30.5 billion. However, if
        illegal immigrants are legalized and could receive affordability
        credits, a much larger percentage would be expected to enroll, with a
        corresponding increase in costs.

    --  Uninsured illegal immigrants tend to use less in health care on average
        than others without health insurance because they tend to be young. This
        fact is incorporated into the current cost estimate of $4.3 billion.
        However, government-provided affordability credits paid to insurance
        companies are the same for everyone regardless of age or preexisting
        conditions. Therefore, the younger age of illegals does not result in
        lower average costs for taxpayers for this program.

    --  It is also worth noting that the report estimates that 38 percent of
        illegal immigrants had health insurance in 2007. Additionally, the
        report estimates that there are at least 360,000 uninsured illegal
        immigrants with incomes above 400 percent of poverty who would not
        qualify for benefits under H.R. 3200.

    --  It is also possible that illegal immigrants could benefit from the
        expansion of Medicaid under H.R. 3200. The bill does not require
        identity verification for those claiming U.S. birth. Of illegal
        immigrants with incomes under 400 percent of poverty, about half live
        under 133 percent of poverty, which is the new ceiling for Medicaid
        eligibility.

    --  On July 30 an amendment by Rep. Nathan Deal (R-GA) that would have
        required identity variation for those claiming U.S. birth was defeated
        by the House Energy and Commerce Committee.

Methodology: To estimate the number of illegal immigrants in the United States this report uses the March 2008 Current Population Survey (CPS) collected by the Census Bureau. While the CPS does not ask the foreign-born if they are legal residents, the Department of Homeland Security (DHS), former INS, and other outside researchers have all used socio-demographic characteristics in Census Bureau data to estimate the size of the illegal alien population; this report follows the same approach. The March CPS also asks about income and health insurance coverage and on this basis the report estimates the share of low-income illegal immigrants who are without health insurance coverage. By design these estimates of the size and characteristics of the illegal-immigrant population match those

The Center for Immigration Studies is an independent research institution that examines the impact of immigration on the United States. It has no position on the health reform legislation before Congress or any other matter unrelated to immigration.