Unauthorized Immigrants Prolong the Life of Medicare's Trust Fund

J Gen Intern Med. 2016 Jan;31(1):122-7. doi: 10.1007/s11606-015-3418-z. Epub 2015 Jun 18.


Background and objective: Unauthorized immigrants seldom have access to public health insurance programs such as Medicare Part A, which pays hospitals and other health facilities and is funded through the Medicare Trust Fund.

Design and main measures: We tabulated annual and total Trust Fund contributions and withdrawals by unauthorized immigrants (i.e., outlays on their behalf) from 2000 to 2011 using the Current Population Survey and Medical Expenditure Panel Surveys. We estimated when the Trust Fund would be depleted if unauthorized immigrants had neither contributed to it nor withdrawn from it. We estimated Trust Fund surpluses by unauthorized immigrants if 10 % were to become authorized annually over the subsequent 7 years.

Key results: From 2000 to 2011, unauthorized immigrants contributed $2.2 to $3.8 billion more than they withdrew annually (a total surplus of $35.1 billion). Had unauthorized immigrants neither contributed to nor withdrawn from the Trust Fund during those 11 years, it would become insolvent in 2029-1 year earlier than currently predicted. If 10 % of unauthorized immigrants became authorized annually for the subsequent 7 years, Trust Fund surpluses contributed by unauthorized immigrants would total $45.7 billion.

Conclusions: Unauthorized immigrants have prolonged the life of the Medicare Trust Fund. Policies that curtail the influx of unauthorized immigrants may accelerate the Trust Fund's depletion.

Keywords: health care financing; immigrants; medicare.

Publication types

  • Multicenter Study

MeSH terms

  • Financial Management / economics*
  • Health Expenditures / legislation & jurisprudence*
  • Health Services Research*
  • Humans
  • Medicare / economics
  • Medicare / legislation & jurisprudence*
  • Retrospective Studies
  • Trust*
  • Undocumented Immigrants / statistics & numerical data*
  • United States