August 2018

August 23, 2018

Much of the increased attention on immigration has been fueled by the belief that immigrants are a financial drain on the American economy, particularly on the health care system. A recently published study finds this claim to be false. 

The meta-analysis, Medical Expenditures on and by Immigrant Populations in the United States: A Systematic Review, written by Boston researchers Lila Flavin, Leah Zallman, Danny McCormick, and J. Wesley Boyd, focused on 16 peer-reviewed studies looking at medical expenditures of immigrant populations in the US. 

They found, contrary to popular belief, that immigrants consume less health care system resources compared to US-born individuals. Foreign-born persons make up 12% of the population, but only contribute to 8.6% of overall expenditures. Among immigrants with insurance, healthcare costs were 52% lower than American-born individuals.  They concluded that,  “Overall, immigrants almost certainly paid more toward medical expenses than they withdrew, providing a low-risk pool that subsidized the public and private health insurance markets.”

The study found that especially for Medicare, immigrants contribute more to the health care system financially than they use. This is particularly true for younger immigrants, found Cato Institute’s immigrant policy analyst, Alex Nowrasteh. Statistically, younger immigrants “pay more into the system than they take out over the course of their lives.” 

“Our review of the literature overwhelmingly showed that immigrants spend less on healthcare, including publicly funded health care, compared to their U.S.-born counterparts,” the authors of the study wrote. “Moreover, immigrants contributed more towards Medicare than they withdrew; they are net contributors to Medicare’s trust fund.”

Consensus seems to have been struck in the public health community: denying immigrants green cards will not fix America’s welfare system, and will increase burden for the federal government. These researchers concluded that government should remove nonfinancial barriers to enrolling in health insurance. In fact, they argue that the US should provide insurance to foreign-born individuals, particularly to newly arrived immigrants, since it would be financially sound to enroll those who (on average) contribute more than they withdraw from the health care system.

The Cato Institute recently conducted a cost-benefit analysis of the proposed regulation that would deny immigrants green cards and thus access to health care coverage, and found that it would cost $1.46 for every dollar saved. The research also showed that this proposed regulation will not protect taxpayer’s money, but will instead backfire and increase spending while negatively impact the health of individuals and communities. The current administration rejects any fiscal connection between immigration and public benefits, citing a lack of research, which is not accurate based on the already available data. Consumers and advocates alike need to continue to work to protect health care access as well as fact-based approaches to health care policy.

-Leah Dreyfus

 

 

August 17, 2018

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All of us at Health Care For All were saddened to hear of the loss of Kate Nordahl this week. Kate was a longtime friend of HCFA who lost her battle to cancer. Kate was a passionate champion of the cause of expanding health coverage, and she devoted herself to advocating on behalf of those most in need.

At the Blue Cross Blue Shield of Massachusetts Foundation, Kate was the Senior Director of Coverage and oversaw the Massachusetts Medicaid Policy Institute, which promotes a thoughtful understanding of the Massachusetts Medicaid program (MassHealth) through policy research and analysis. She also directed the Foundation's Massachusetts Health Reform Survey (MHRS), which tracks trends in access and affordability of health care and health insurance. Since 2006 the MHRS has highlighted health reform’s successes and areas that still need improvement to meet the goal of accessible, affordable health coverage for all.

Prior to her time at the Foundation, Kate served as assistant commissioner for the Massachusetts Division of Health Care Finance and Policy, where she led the agency's work monitoring the impact of the state's health reform law and analyzing health care cost trends in the Commonwealth. Prior to her role at the Division, Kate was director of policy and research at the Blue Cross Foundation where she developed the Foundation's research agenda to assess the impact of health reform.

Kate also spent 12 years in leadership positions with MassHealth in roles ranging from directing the MassHealth managed care program to designing the Senior Care Options (SCO) program for seniors dually eligible for Medicare and Medicaid. SCO has served as a national model for integrating payment and care delivery for seniors on Medicaid and Medicare. While at MassHealth she was also in charge of the state’s Medicaid managed care contracts, which served about a third of the under-65 Medicaid population.

In 2016, Kate was honored with the Boston Center for Independent Living's Marie Feltin Award for her work advancing innovative Medicaid policy and programs in Massachusetts. She also held a master's degree in health policy and management from the Harvard School of Public Health.

As we mourn Kate, our thoughts are with her family, her husband Erik and two children. The family suggests that donations in her memory may be made to the Kate Willrich Nordahl Fellowship Fund at the Harvard T.H. Chan School of Public Health,  P.O. Box 419209, Boston, MA 02241 by check or online at hsph.harvard.edu/give (please specifically note the Kate Willrich Nordahl Fellowship Fund). The fellowship will support a graduate student who has demonstrated passion and commitment to social justice and health equity.

We will remember Kate for her lifelong commitment to making people’s lives better by working passionately to improve health care in Massachusetts.

                                                                                                                                                                  -- Louis Pratt