Health Affairs
June 2013
Immigrants Contributed An Estimated $115.2 Billion More To The Medicare Trust Fund Than They Took Out In 2002–09
Leah Zallman, Steffie Woolhandler, David Himmelstein, David Bor and Danny McCormick
Abstract
Many immigrants in
the United States are working-age taxpayers; few are elderly
beneficiaries of Medicare. This demographic profile suggests that
immigrants may be disproportionately subsidizing the Medicare Trust
Fund, which supports payments to hospitals and institutions under
Medicare Part A. For immigrants and others, we tabulated Trust Fund
contributions and withdrawals (that is, Trust Fund expenditures on their
behalf) using multiple years of data from the Current Population Survey
and the Medical Expenditure Panel Survey. In 2009 immigrants made 14.7
percent of Trust Fund contributions but accounted for only 7.9 percent
of its expenditures—a net surplus of $13.8 billion. In contrast, US-born
people generated a $30.9 billion deficit. Immigrants generated
surpluses of $11.1–$17.2 billion per year between 2002 and 2009,
resulting in a cumulative surplus of $115.2 billion. Most of the surplus
from immigrants was contributed by noncitizens and was a result of the
high proportion of working-age taxpayers in this group. Policies that
restrict immigration may deplete Medicare’s financial resources.
Conclusion
Having ourselves
witnessed immigrants dying needlessly because of lack of health care,
we (and many of our colleagues) are motivated by the belief that all
patients have a human right to health care. But economic
concerns—including the worry that immigrants are driving up US health
care costs—have often dominated the debate over immigration. Our data
offer a new perspective on these economic concerns.
Policies that reduce immigration would almost
certainly weaken Medicare’s financial health, while an increasing flow
of immigrants might bolster its sustainability. Because Social
Security’s eligibility criteria and payroll tax–based funding closely
track those of Medicare, our findings support the argument that
immigration helps sustain Social Security.
Providing a path to citizenship for currently
undocumented immigrants would affect Medicare’s finances in multiple
ways. 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.
However, the age structure of the immigrant
population is far more important than either of these factors.
Encouraging a steady flow of young immigrants would help offset the
aging of the US population and the health care financing challenge that
it presents.
Comment: Everyone should have health care when needed. Immigrants
are taxed to support our Medicare program, yet many of them are
prohibited from participating in Medicare, Medicaid, and the state
insurance exchanges currently under development. Not fair.
We should have a universal health care financing
system - covering all of us - in which we pay in, based on ability, and
draw out, based on medical need. As long as immigrants are an integral
part of our society, they should be included on the same basis.
No comments:
Post a Comment