A dose of reality about the cost of Immigration Reform

[HM2VikingRN, RN]

• from cbpp:
  
  • cbo found that over the next ten years, the net effect of the bill's impact on entitlement costs and revenues would be a small negative effect on the budget, with the new expenditures exceeding the new revenues by $4.8 billion.
    
  • over the longer term, however, the bill's fiscal effects in the entitlement-and-tax area likely would be positive. the effects would be positive (i.e., they would reduce deficits) if the new revenues resulting from the bill rose faster than the new entitlement costs. according to cbo's analysis, that is precisely what would occur over the next ten years. in fact, over the second half of the ten-year period covered by the cost estimate (2012-2016), the estimated increase in revenues exceeds the estimated increase in entitlement costs by $6.3 billion. in 2016, the tenth year, cbo estimates that revenues would be $11.1 billion higher as a result of the bill while entitlement costs would be $8.5 billion higher-resulting in a net gain for the federal government of $2.6 billion, exclusive of any increases in discretionary spending costs.
    
  • the new cbo analyses do not extend beyond the ten-year window, but the pattern at the end of the ten-year period suggests that federal revenue gains over the long term may equal or exceed the increases in entitlement expenditures.
    

somehow i think this analysis pokes a hole in the immigrant bashing that has been going on around here lately.

[pickledpepperRN]

Health care beliefs questioned

Report: Immigrants not to blame for crisis in medical costs

As Gov. Arnold Schwarzenegger and state lawmakers seek ways to care for millions of Californians without medical insurance, a study released Wednesday says policy changes will be difficult to implement because of differences in how residents use the health care system.

The 183-page report by the Public Policy Institute of California also dispels some commonly held beliefs, finding that immigrants and their children generally don't seek care at hospitals and emergency rooms any more often than U.S.-born residents.

LA Daily News - Health care beliefs questioned

[NRSKarenRN, BSN, RN]

[color=#333366]jobs lacking coverage biggest reason for immigrants' low insured rates

policy perspective

the economics behind these findings is pretty clear. employers offer health insurance to recruit and retain workers with the skills they need. the problem for some groups of workers is that many low-paying jobs and jobs with small firms don't come with an offer of health insurance. most working adults aren't eligible for public coverage, especially non-citizens. as a result, some workers who would take up an offer of health insurance at an actuarially fair rate are not able to get a job with such an offer. as this research shows, the problem for immigrant workers in this category is not about attitudes or preferences: immigrants are just as willing to work and to purchase available coverage as other groups. the problem is the reliance on employment-based coverage for adult workers. the cost of this coverage is increasingly out of reach for many workers and working families, independent of immigration status. in a sense, non-citizen immigrants are the "canary in the mine" for health insurance woes in the u.s. their lack of access to employment-based coverage is more pronounced than other groups, but signals the vulnerability many face as employment-based coverage becomes more difficult and costly to secure.

from catherine mclaughlin, ph.d., professor at the university of michigan and director of eriu

[NRSKarenRN, BSN, RN]

information provided by the kaiser commission on medicaid and the uninsured

publication number: 7411

publish date: 2005-11-04

are immigrants responsible for most of the growth of the uninsured?,

this analysis examines how much immigrants are contributing to the increasing uninsured population from 1994 to 2003.

if we combine the data from 1998 to 2003, we find that almost two-thirds of the increase of uninsured was among non-citizens (and somewhat more if we include the effects of reweighting as detailed in the body of this report). but this result is largely driven by the reduction in the number of uninsured native citizens between 1998 and 2000. this period seems an

aberration because of extremely rapid economic growth and very tight labor markets, which disproportionately improved health coverage for native citizens. in contrast, the results from 1994-1998 period and from 2000-2003 period indicate that the growth in the uninsured is largely among native citizens.

because there are so many more native citizens than non-citizens, it is not surprising that they "bear the brunt" of most economic changes including changes in insurance. immigration trends are not responsible, in large part, for the increase in the numbers of uninsured in this country. indeed, non-citizens would have to fare dramatically worse than native citizens in terms of changes in health coverage rates to affect the overall numbers of uninsured.

*************

mohanty, s.a., s. woolhandler, e.u. himmelstein, et al.

august 2005, vol 95, no. 8 | american journal of public health 1431-1438

© 2005 american public health association

using data from the 1998 medical expenditure panel survey, this analysis compares the health care expenditures of immigrants residing in the united states with health care expenditures of us-born persons.

health care expenditures of immigrants in the united states: a nationally representative analysis.

results. immigrants accounted for $39.5 billion (se=$4 billion) in health care expenditures. after multivariate adjustment, per capita total health care expenditures of immigrants were 55% lower than those of us-born persons ($1139 vs $2546). similarly, expenditures for uninsured and publicly insured immigrants were approximately half those of their us-born counterparts. immigrant children had 74% lower per capita health care expenditures than us-born children. however, ed expenditures were more than 3 times higher for immigrant children than for us-born children.

conclusions. health care expenditures are substantially lower for immigrants than for us-born persons. our study refutes the assumption that immigrants represent a disproportionate financial burden on the us health care system.

**************

fronstin, p. june 2005. the impact of immigration on health insurance coverage in the united states. employee benefit research institute 26(6).

this newsletter looks at the effect of immigrants on the nation's overall health expenditures and its ability to provide health insurance for uninsured citizens.

***************

goldman, d.p., j.p. smith, and n. sood. november/december 2005. legal status and health insurance among immigrants. health affairs 24(6):1640-1653.

this analysis uses data from los angeles county to examine the legal and health insurance status of the foreign-born adult population.

the foreign-born represent a disproportionate share of nonelderly u.s. adults without health insurance. using data from los angeles county, we find that most of the insurance disparities between the foreign-born and native-born can be explained by traditional socioeconomic factors. undocumented immigrants, however, have lower rates of coverage--both private and public--even after a wide array of factors are controlled for.

applying los angeles county rates to the u.s. population implies that undocumented immigrants account for one-third of the total increase in the number of uninsured adults in the united states between 1980 and 2000.

[NRSKarenRN, BSN, RN]

alker, j., and m. urrutia, national council of la raza and the kaiser commission on medicaid and the uninsured, immigrants and health coverage: a primer, october 2004.

this primer is designed to provide an introduction to some of the questions surrounding immigrants and health insurance coverage.

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fremstad, s., and l. cox, kaiser commission on medicaid and the uninsured, covering new americans: a review of federal and state policies related to immigrants' eligibility and access to publicly funded health insurance, november 2004.

this brief provides an overview of health coverage challenges facing immigrants, the federal rules regarding immigrants' eligibility for medicaid and schip, and state efforts to provide replacement coverage for immigrants who are ineligible for medicaid and schip. it also reviews actions states can take to encourage enrollment of eligible immigrants in public health coverage and to improve immigrants' access to care.

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more info availalbe at [color=#333333]kaiseredu.org:

[color=#394b6b]immigrants: coverage & access to care : policy research

[HM2VikingRN, RN]

from mother jones: http://www.motherjones.com/interview/2006/03/sonia_nazario-4.html

what a lot of folks who work with immigrants up and down the rails in mexico say is that it would be better if the united states could improve the economies of countries that send a lot of immigrants here – mexico, honduras – so that immigration would not hurt neediest americans, and these women could stay working in these countries alongside their children. and that there should be different ways in which the u.s. uses foreign policies or trade policies aimed at trying to help countries that send most immigrants to the united states. we must address the factors pushing people out of those few countries rather than simply building walls. the building walls won’t work unless other side of equation is addressed. that’s the point that i heard strongest from people who help and work with immigrants along the rails.

[Elvish, BSN, DNP, RN, NP]

HM2Viking, the woman being interviewed in that article is Sonia Nazario, the author of Enrique's Journey, which is an excellent book about immigrants and their struggle to get here and live here. It is an excellent book that is very easy to read with no easy answers on either side of the border. Thanks for bringing that up.

Nice thread, and a breath of fresh air.