Summary: Some experts say the true cost of illegal immigrants to the public health system is impossible to estimate.
Analysis: Asked to explain his position, Brooks was quick to point out his estimate of “billions” for immigrant health costs was not supposed to be in one year. He cited as sources a USA Today article on costs in Texas; Mi-chael Ciamarra, Alabama Policy Institute president; The Employee Benefit Research Institute; and The Institute of Medicine.
Brooks also referred to half a dozen other sources, including the Florida Hospital Association, the U.S.-Mexico Bor-der Counties Coalition, the Los Angeles County Department of Health and the New Jersey Hospital Association. Those sources gave estimates on cost of care for undocumented immigrants in the millions and sometimes hundreds of millions for their areas alone.
Alabama Policy Institute’s Ciamarra said questions persist about the financial impact of illegal immigrant care on hospitals. Hospitals do not usually collect information about whether patients are illegal immigrants, partly because of federal regulations.
James Smith, a senior economist with The RAND Corp., told USA Today for a 2008 story that health care spending for illegal immigrants accounted for less than 2 percent of national medical spending. Many undocumented immi-grants are young and healthy, Smith said. But states with the largest undocumented populations, including Arizona, California, Florida, Texas and North Carolina, bore a larger-than-average financial burden for such care.
Samuel N. Addy, director of the Center for Economic and Business Research at the University of Alabama, said il-legal immigrants often operate in a “shadow culture,” making documentation difficult. The lack of documentation makes figuring accurate costs impossible, he said.
The Pew Hispanic Center estimated 60 percent of illegal immigrants do not have health insurance. Hospital emer-gency rooms bear the financial brunt of uncompensated care. But in a March study, Pew cited figures on dropping numbers of undocumented workers entering the U.S. each year, citing fewer job opportunities.
A December 2007 study by the Congressional Budget Office looked at the cost of unauthorized immigrants on the budgets of state and local governments. The study said authorized and unauthorized immigrants were less likely than native-born Americans to have health insurance. As a result, they are more likely to rely on emergency rooms or public clinics for medical care. The federal government does provide funds to help offset hospital and state expenses for uninsured care, but not enough to cover all costs.
Like the Pew Hispanic Center, the Congressional Budget Office study found no way to accurately estimate the costs of illegal immigrant health care. No study explored how funds now believed spent on undocumented immigrant care could transfer to care for U.S. citizens.