Immigrants pay Medicare more than what they receive in care

Immigrants paid $115.2 billion more into Medicare’s trust fund from 2002 to 2009 than they incurred in benefits, according to a study published online May 29 in Health Affairs.

Population data show that immigrants, both U.S. citizens and noncitizens, made 14.7% of trust fund contributions but accounted for only 7.9% of Medicare spending under the hospital benefit of the program in 2009. This left a net surplus of $13.8 billion to Medicare from immigrants for that year.

Other studies have found that immigrants consume less health care than U.S.-born patients, but the role immigrants play in Medicare has not been fully understood, wrote lead author Leah Zallman, MD, an internist and an instructor of medicine at Harvard Medical School in Boston. The Health Affairs study estimated Medicare spending on foreign-born citizens and noncitizens using data from medical expenditure surveys (link).

Immigrants accounted for 4.8% of hospitalization spending, 14.2% of home health expenditures and 11.8% of trust fund spending on Medicare Advantage premiums. On average, spending was nearly $1,500 lower for immigrants than for other Medicare enrollees.

“Providing a path to citizenship for currently undocumented immigrants would affect Medicare’s finances in multiple ways,” Dr. Zallman and her colleagues wrote. “It would likely increase payroll tax collections by reducing immigrants’ ‘off the books’ employment and removing barriers that keep them out of higher-paying jobs. But in the long term, it would probably increase the number of immigrants eligible for Medicare, and hence expenditures on their behalf.”

Still, younger immigrants could help offset the price of care for the aging U.S. population, the study stated. Some of the authors are involved with Physicians for a National Health Program, which supports a single-payer health system in the U.S.