Date: 24/05/2019
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The Cost of Providing Health Care to Illegal Aliens

The most objective piece of writing on illegal immigration to emerge from the legacy media last week appeared under the title, “If We Want to End the Border Crisis, It’s Time to Give Trump His Wall.” It was penned by Andrew Sullivan, of all people, yet he admitted something few progressives have really accepted: “He won the election. He is owed this.” Sullivan’s regular readers will reflexively disagree, but his reasoning is irrefutable. So, most will have to revert to the “prohibitive cost” canard. In reality, the wall will easily pay for itself in savings to our health care system.

The cost of the border wall has been projected by numerous entities, and the estimates vary wildly. The Trump administration and the GOP congressional leadership have estimated its cost at $12 billion to $15 billion. Senate Democrats claim that the price tag would be $67 billion. The Department of Homeland Security (DHS) has projected the cost at $21.6 billion. Going with the Trump administration figure, the savings to our health care system should pay for the thing in a decade. Using the DHS figure, it will take far less time than a typical mortgage. Specifically, about 20 years.

This depends on what we pay for the health care we provide to illegal immigrants and how many will be stopped by the wall. Neither of these figures is easy to calculate, but it’s clear that most estimates we see in the media understate both. To hit the payoff goals noted above we would need to stop 500,000 people per year from illegally entering the country and eliminate an equal number from the Medicaid and Obamacare rolls. That would save $1.3 billion annually in medical costs. According to the Kaiser Family Foundation, we spend nearly twice that on illegal aliens for emergency Medicaid alone:

Federal law generally bars illegal immigrants from being covered by Medicaid. But a little-known part of the state-federal health insurance program for the poor has long paid about $2 billion a year for emergency treatment for a group of patients who, according to hospitals, mostly comprise illegal immigrants.

Most of this money pays for delivering babies when patients materialize in emergency rooms in active labor. Pursuant to the Emergency Medical Treatment and Active Labor Act (EMTALA), all hospitals must provide emergency medical treatment to all comers regardless of ability to pay or any other consideration. It is common for women of obviously foreign descent and no English to appear in ERs just as they are about to give birth. Hospitals cannot turn them away (and wouldn’t do so if they could). Medicaid retroactively covers them and pays some of the treatment costs.

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