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Immigrants Contributed An Estimated $115.2 Billion More To The Medicare Trust Fund Than They Took Out In 2002-09


Bethesda, MD -- In 2009 immigrants in the United States accounted for a net surplus of $13.8 billion paid into the Medicare Hospital Insurance Trust Fund, while native-born Americans were responsible for depleting the fund of $30.9 billion. This finding from a study being released today as a Web First by Health Affairs, suggests that immigrants heavily subsidize Medicare. This study is the first to quantify immigrants' share of contributions to this fund.


The authors tabulated contributions from the Current Population Survey, data generated by the Census Bureau and Bureau of Labor Statistics, and expenditures from the Medical Expenditure Panel Survey, conducted by the Agency for Healthcare Research and Quality. They then calculated net contributions (contributions minus expenditures) for immigrants, noncitizen immigrants, and native-born Americans for each year between 2002 and 2009.


The study found that immigrants generated surpluses of $11.1-17.2 billion per year between 2002 and 2009, resulting in a cumulative surplus of $115.2 billion to the fund that primarily pays hospitals and institutions under Medicare Part A. In 2009 the final year examined in this study, 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 to Medicare, the majority of which was attributable to noncitizen immigrants.

Immigrants Contributed An Estimated $115.2 Billion More To The Medicare Trust Fund Than They Took Out In 2002-09


By Leah Zallman, Steffie Woolhandler, David Himmelstein, David Bor, and Danny McCormick


All authors are associated with Harvard Medical School and Cambridge Health Alliance in Massachusetts. Woolhandler and Himmelstein are also associated with the City University of New York at Hunter College.


The study will also appear in the June issue of Health Affairs.


"Immigrants generate a surplus for Medicare primarily because so many of them are working age adults. That group has a high labor-force participation rate--a combination that generates large payroll tax payments," concluded the authors. "[E]conomic 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."

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.