Even though illegal aliens are in theory, unable to tap federal money through the Medicaid and ACA programs, there are exceptions and loopholes that cost federal, state and local taxpayers $18.5 billion a year.
The main exception is for emergency medical care, such as a heart attack or a car accident. The loopholes are everywhere. In both the Medicaid and ACA programs, the taxpayers subsidize hospitals for patients with no insurance but it does not distinguish between eligible expenses and those for illegal aliens.
In California, state tax payers pay to insure all illegal aliens through their state program.
Uninsured Unauthorized Immigrants. According to Pew Research Center, there were 11.3 million unauthorized immigrants in the U.S. in 2016. Currently, 14% of the uninsured (3.9 million) are unauthorized immigrants who are ineligible for both Medicaid and ACA coverage under federal law. For purposes of discussion, I am going to focus principally on financing health care for unauthorizedimmigrants who are uninsured since we know that about 70% of care for America’s uninsured is uncompensated, meaning that ultimately it is paid for by society in one way or another.
Specifically, in 2013 (the latest available such figures), America’s uninsured generated $84.9 billion in uncompensated care costs [Table 2] or $1,257 per person who was ever uninsured that year [Table 1]. Of this:
- 39% was covered by various federal programs (e.g., disproportionate share payments to hospitals);
- 23% by state and local governments (e.g., via taxpayer support of state and locally owned hospitals);
- 12% came in the form of physician charity care covered;
- 25%–was covered by hospitals (arguably by “cost-shifting” i.e., higher charges to privately insured patients that effectively cross-subsidize care for patients who do not pay full freight etc.). An unknown fraction of this stems from EMTALA–the Emergency Treatment and Active Labor Act–a federal law that requires hospitals to treat emergency patients regardless of their ability to pay. EMTALA is an example of “taxation by regulation” insofar as the same outcome might have been achieved by using tax dollars to pay hospitals to treat such patients voluntarily.
Assuming unauthorized immigrants received a pro rata share of such support (i.e., 14%), they account for the $11.9 billion in uncompensated care costs, financed as follows:
- $4.6 billion–federal taxpayers
- $2.8 billion–state and local taxpayers
- $3.0 billion–hospital charity care/bad debts arguably cost-shifted to private patients
- $1.5 billion–physician charity care
If illegals did not have such easy access to our country, how many years would it take to pay for the border wall? The border wall would cut all new expenditures. All told, we spend $166 billion a year on illegals and we could save enough to pay for the wall in just 2 to 3 years. Name one private business that wouldn’t jump on a deal like that.