Posted on July 27, 2005

Immigrants' Health Care Costs are Low


July 25, 2005

Sarita A. Mohanty, M.D. (323) 226-5579 (office)
Steffie Woolhandler, M.D. (617) 312-0970 (cell)
Olveen Carrasquillo, M.D. (917) 899-5403 (pager)
Nicholas Skala (312) 782-6006 (office)
(Additional contact info below)

Immigrants’ Health Care Costs are Low
Use Half as Much Care as Non-Immigrant Americans

Immigrants in the U.S. receive surprisingly little health care - 55% less than native-born Americans -according to a Harvard/Columbia University study that appears in the current issue of the American Journal of Public Health. Immigrant children received particularly low levels of care, 74% less overall than other children.

According to the study, immigrants accounted for 10.4% of the U.S. population, but only 7.9% of total health spending, and only 8% of government health spending. Per capita health expenditures averaged $1,139 per immigrant vs. $2,564 for non-immigrants. 30% of immigrants used no healthcare at all in the course of a year.

Most immigrants had health insurance coverage. Though uninsured immigrants used the least health care of any group - 61% less than US-born persons who were uninsured - even immigrants with coverage used 52% less health care than insured non-immigrants.

Immigrant children received far less care in doctors’ offices (71% less than non-immigrant children) and received 72% less prescription medications. Immigrant children had a significantly lower average number of emergency room visits than non-immigrant children. However, their emergency room costs - $45 per child - were nearly three times greater – suggesting that immigrant children forewent care until becoming very ill.

The study is the first nationwide analysis of immigrants’ health care expenditures. The researchers analyzed data on 21,241 people in the Agency for Healthcare Research and Quality’s 1998 Medical Expenditure Panel Survey, which collects detailed health spending data on a representative cross-section of Americans. They used statistical techniques to adjust comparisons between immigrants and non-immigrants for differences between the two groups in age, race/ ethnicity income, health status, and insurance status.

Dr. Sarita Mohanty, who led the study while she was at Harvard and is currently an Assistant Professor of Medicine at the University of Southern California, commented: “Our study lays to rest the myth that expensive care for immigrants is responsible for our nation’s high health costs. The truth is, immigrants get far less care than other Americans. Further restricting their eligibility for care would save little money and place many immigrants – particularly children – at grave risk. Already, many immigrant children fail to get regular checkups, and as a result more end up needing emergency care, or get no care at all.”

“Our data indicates that many immigrants are actually helping to subsidize care for the rest of us. Immigrant families are paying taxes – including Medicare payroll taxes - and most pay health insurance premiums, but they’re getting only half as much care as other families.” said Dr. Steffie Woolhandler, a study co-author and co-founder of Physicians for a National Health Program.

According to study co-author Dr. Olveen Carrasquillo of Columbia University’s College of Physicians and Surgeons: “Latino immigrants had the lowest health expenditures - $962 per person - half those of US-born Latinos ($1,870) and less than one third those of US-born whites ($3,117). The future economic success of the United States depends on a healthy immigrant workforce. Our findings suggest an urgent need for partnerships between health organizations and community groups to improve access to care, particularly for minority immigrants. This study shows that a national health program that includes all immigrants would cost much less than is widely assumed.”


Physicians for a National Health Program is an organization of 13,000 physicians advocating for non-profit national health insurance. PNHP has chapters and spokespersons across the country. For contacts, call (312) 782-6006

Additional Contact Information

Sarita A. Mohanty, M.D.
(Department of Medicine, University of Southern California)
(323) 226-5579
(818) 425-3618 (cell)

Steffie Woolhandler, M.D.
(Department of Medicine, Harvard University)
(518) 794-8109
(617) 665-1032
(617) 312-0970 (cell)

Olveen Carrasquillo, M.D.
(Division of General Medicine, Columbia University)
(212) 305-9782
(917) 899-5403 (page)
(917) 882-3770 (cell)

Background Fact Sheet
Health Care Expenditures for Immigrants in the United States

1- The U.S. immigrant population was 28.4 million in 2000, or 10.4% of the population, but immigrants account for 7.9% of U.S. health care expenditures ($39.5 billion in 1998), significantly less than their proportion of the population.

2- Immigrants utilize 55% less health care than U.S.-born residents ($1,139 vs. $2,546 per capita).

3- Immigrant children visit emergency rooms significantly less than non-immigrant children, but their individual ER costs are nearly three times higher ($45 vs. $18 per capita), suggesting that immigrant children forego needed care until experiencing an emergency.

4- Immigrant children utilize 74% less health care than U.S.-born children ($270 vs. $1,059 per capita).

5- Immigrant children utilize 71% less doctors’ care, 90% less inpatient hospital care, and 72% less prescription medications than U.S.-born residents.

6- 30% of immigrants utilize no health care in the course of a year compared to 20% of U.S.-born residents.

7- Immigrants utilize less health care per capita regardless of insurance status including those with private insurance ($1,711 vs. $1,906 for U.S.-born) and those with public insurance ($2,749 vs. $3,447).

8- Immigrants are more likely to be uninsured than U.S.-born residents (24.6% vs. 10.0%) but utilize less health care than other uninsured residents ($459 vs. $629 per capita).

9- Per capita, immigrants utilize 64% less emergency department care, 49% less doctors’ care, 31% less inpatient hospital care, and 69% less on prescription drugs than U.S.-born residents.

10- Latino immigrants utilize half as much health care as U.S.-born Latinos (49% less) and less than one third of U.S.-born whites (70% less).

11- It is estimated that immigrants will pay, on average, $80,000 more in taxes than they will use in government services over their lifetimes (The New Americans: Economic, Demographic, and Fiscal Effects of Immigration, National Academy Press, 1997).

12- For the purposes of the study, immigrant was defined as being born in a foreign country. The data contains no information about citizenship or legal status.

Health Care Expenditures for Immigrants in the United States
All figures are annual per capita unless otherwise noted

Total health care spending
U.S.-born: $2,546
Immigrants: $1,139

Emergency department costs
U.S.-born: $91
Immigrants: $33

Office visit costs
U.S.-born: $410
Immigrants: $209

Inpatient hospital care costs
U.S.-born: $932
Immigrants: $634

Prescription drug costs
U.S.-born: $507
Immigrants: $159

Costs for whites (non-Hispanic)
U.S.-born: $3,117
Immigrants: $1,747

Costs for Hispanics
U.S.-born: $1,870
Immigrants: $962

Costs blacks (non-Hispanic)
U.S.-born: $2,524
Immigrants: $1,030

Data by insurance status

Private insurance
U.S.-born: 74.9%
Immigrants: 58.1%

Public insurance
U.S.-born: 15.0%
Immigrants: 17.3%

U.S.-born: 10.0%
Immigrants: 24.6%

Per capita expenditures for uninsured
U.S.-born: $629
Immigrants: $459

Data on children (per capita):

Total health care spending
U.S.-born: $1,059
Immigrants: $270

Average number of emergency department visits
U.S.-born: 15 visits/100 children
Immigrants: 6 visits/100 children

Emergency department costs
U.S.-born: $18
Immigrants: $45

Average number of office visits
U.S.-born: 278 visits/1000 children
Immigrants: 108 visits/1000 children

Office visit costs
U.S.-born: $215
Immigrants: $63

Inpatient hospital care costs
U.S.-born: $167
Immigrants: $16

Prescription drug costs
U.S.-born: $86
Immigrants: $24

Data from the Agency for Healthcare Research and Quality’s 1998 Medical Expenditure Panel Survey (MEPS) and the 1996-1997 National Health Interview Survey (NHIS).

Source: Sarita A. Mohanty, Steffie Woolhandler, David U. Himmelstein, Susmita Pati, Olveen Carrasquillo, and David H. Bor. “Health Care Expenditures of Immigrants in the United States: A Nationally Representative Analysis.” American Journal of Public Health 2005; 95.