Increasing the Ranks of the Uninsured
Immigration and the Growth of the Population Without Health Insurance

WASHINGTON (July 18, 2000) -- The rapid increase in the number of people without health insurance is one of the most troubling social trends in recent years. Both presidential candidates have proposed major new initiatives costing billions of dollars to address the problem. But neither has addressed a core reason for this problem -- mass immigration. A new report from the Center for Immigration Studies finds that the nation's health insurance crisis is being driven to a significant extent by immigration policy.

The study, entitled Without Coverage: Immigration's Impact on the Size and Growth of the Population Lacking Health Insurance by the Center's Director of Research, Steven A. Camarota, and James R. Edwards Jr. of the Hudson Institute, contains detailed information on immigrant and native insurance coverage at the national level, as well as for the major immigrant-receiving states and cities.

The report is on line at http://www.cis.org/

Among the report's findings:

• In 1998, 32.4 percent of persons living in immigrant households (primarily immigrants and their young children) lacked health insurance -- more than twice the 13.9 percent of persons in native households.



• Immigrants who arrived between 1994 and 1998 and their children accounted for an astonishing 59 percent or 2.7 million of the growth in the size of the uninsured population since 1993.



• The total uninsured population is one-third larger (32.7 million versus 44.3 million) when the 11.6 million persons in immigrant households without insurance are counted.

"The debate over the growing number of uninsured in this country has failed to take into account the enormous impact of immigration on the nation's health insurance crisis," said Camarota. "Our findings show that we cannot hope to contain health care costs or reduce the number of uninsured in the U.S. without addressing the role of immigration policy."

Among other findings in the new report:

• Immigration has made it much more difficult to reduce the size of the uninsured population. For example, in just the last few years immigration has increased the number of uninsured children in the United States by more than 700,000, enough to offset most of the gains made so far under the new State Children's Health Insurance Program enacted by Congress in 1997 at a cost of $4 billion a year.



• Lack of insurance remains a severe problem even after immigrants have been in the country for many years. In 1998, 37 percent of immigrants who entered in the 1980s still had not acquired health insurance, and 27.2 percent of 1970s immigrants were uninsured.



• The low rate of insurance coverage associated with immigrants is primarily explained by their much lower levels of education and their resulting higher poverty rates relative to natives. 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 purchase insurance on their own.

Factors Not Accounting for the Lack of Coverage Associated with Immigrants

• Although a very high percentage do not have health insurance, illegal aliens only comprise an estimated 26.8 percent of the uninsured living in immigrant households.



• The denial of benefits to some legal immigrants enacted as part of welfare reform in 1996 is not the reason so many persons in immigrants household are uninsured. Before welfare reform was enacted, nearly 31 percent of persons in immigrant households lacked health insurance, very similar to the current rate. Moreover, immigrant households continue to use Medicaid at higher rates than natives.

Who Cares?

By dramatically increasing the size of the uninsured population, immigration strains the resources of health care providers who provide services to the uninsured already here. Moreover, Americans with insurance have to pay higher premiums as health care providers pass along some of the costs of treating the uninsured to paying costumers. Taxpayers too, are affected as federal, state and local governments struggle to provide care to the growing ranks of the uninsured. There can be no doubt that by dramatically increasing the size of the uninsured population, our immigration policy has broad-ranging effects on the nation's entire health care system.

Policy Implications

If current immigration policy remains in place, the Census Bureau estimates that 11 million new immigrants are likely to settle permanently in the United States in the next decade alone, and the number of persons in immigrant households without health insurance could grow to 14 million. If we are ever to deal effectively with the health insurance problem in this country, part of the solution must include the adoption of an immigration policy which admits far fewer unskilled immigrants. We must also develop an immigrant policy that expands access to health insurance to immigrants and their children already here.

For a printed copy of the report, send $12 to the Center for Immigration Studies, 1522 K St. N.W., Suite 820, Washington, DC 20005. The Center is a non-profit non-partisan research organization which examines and critiques the impact of immigration on the United States.

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