Medicare and Medicaid Spend More on Native-Born Americans Than Immigrants

“What this allows the survey to demonstrate is that between 2002–2022—with the exceptions of 2004–2006 and 2013, in which no birthplaces were recorded—foreign-born respondents accounted for 18.6 percent less Medicare and Medicaid spending than their native-born counterparts. On average, this amounted to $1,775 per person in 2022 dollars, compared to $2,180 per person among those born in the U.S.

Bier breaks down the numbers even further to demonstrate that this trend holds across each year in the sample for which data was available: In 2022, the most recent year recorded, U.S.-born patients cost the health agencies $2,691 apiece, while foreign-born cost $2,116 each. The closest the two groups ever came to parity was in 2015, when the U.S.-born cost $2,312 and the foreign-born cost $2,233.

“Despite their lower incomes, immigrants are less likely to use publicly funded health care for several reasons,” Bier writes. “Most importantly, they are younger, but even controlling for age, immigrants tend to be healthier and participate in fewer high-risk activities. In addition, their eligibility for Medicare and Medicaid is more limited than for the US-born population….Finally, some eligible immigrants also do not enroll in these programs out of ignorance or fear about its immigration effects.””

“The survey only notes a respondent’s birthplace, not their immigration status.”

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