hen Donald Trump put out his health care plan late Wednesday, he mentioned just one number: $11 billion.
He claims that’s the annual cost of providing health care to undocumented immigrants — and an opportunity for big savings, if those here illegally could just be deported or prevented from coming to the United States in the first place.
But experts say that’s nonsense.
“Using that figure to talk about the amount of money that you could potentially save with an aggressive deportation program is just patently absurd,” said Michael Gusmano, an associate professor of health policy at Rutgers University.
Here are four problems that experts identified with Trump’s argument:
He’s probably counting spending on US citizens
Trump didn’t cite a source for the $11 billion number, and his campaign didn’t respond to questions.
Experts said the likely source was a 2009 estimate by the Federation for American Immigration Reform, which calls for reducing immigration to the United States.
FAIR estimated $10.8 billion a year in federal, state, and local spending on health care not just for undocumented immigrants but also for their children born in the United States. Those children, of course, are American citizens.
Ira Mehlman, a spokesperson for FAIR, said it makes sense to include about $2 billion in health care spending on the children. “If the parents were not here in violation of the law, the taxpayers would not be responsible for these costs,” he said.
But Gusmano, who’s also codirector of The Hastings Center’s “Undocumented Patients” project, called that analysis “deeply troubling.”
Data on the cost of immigrant health care is sketchy
We don’t actually know much money is spent on health care for undocumented immigrants.
They’re a tough population to track, especially because hospitals and clinics often don’t collect data on immigration status.
Mehlman said FAIR made “reasonable estimates” given the limitations. “Just because there are holes in the data doesn’t mean we shouldn’t be trying to come up with some sort of figure as to how much it’s costing the American public,” he said. “If somebody’s got better data, bring it on.”
Whatever the actual number is, it’s a drop in the bucket
Just about everyone agrees that health care costs are rising at an unsustainable rate.
But experts said health care spending on undocumented immigrants represents such a tiny fraction of total expenditures that it’s silly to frame it as a way to get systemic costs down.
State and local governments spent $515 billion on health care in 2014, according to the Centers for Medicare and Medicaid Services.
So even if a full $11 billion could be saved by deporting undocumented immigrants, that amounts to just 2 percent of state and local spending — and it doesn’t even begin to make a dent in the $844 billion of federal spending on health care.
“This is pretty, pretty small. It would be closer to a blip” on the radar screen, said Raymond Scheppach, a professor of public policy at the University of Virginia. He’s studied the big drivers of rising health care costs and points to overall hospital spending, prescription drugs, and pricey technology, not immigrant care.
Immigrants don’t use a lot of services
Undocumented immigrants tend to be younger than the general population, so they don’t need as much expensive care. They often don’t have insurance, so they’re less likely to see doctors and dentists. They’re also less likely to bring their children to get treated.
A 2013 study led by Harvard Medical School researchers found that immigrants, in general, pay billions of dollars more into Medicare each year, through payroll taxes, than they get back through use of services. Undocumented immigrants who use fake Social Security numbers to obtain jobs pay some of those taxes.
“To suggest that this population drains the system is only seeing part of the story,” said Nancy Berlinger, the other codirector of The Hastings Center’s “Undocumented Patients” project.