Imagine being an undocumented immigrant in the United States, working long hours, contributing to the economy, and paying taxes, yet unable to see a doctor because you do not have health insurance. There is an emergency room, but the costs are too high. If it were a life-or-death situation for someone who is an undocumented immigrant, unfortunately, they would not be able to get the necessary healthcare. In reality, 11 million people who are undocumented immigrants must face everyday life without healthcare.
In the United States, unless someone is willing to take on massive debt, health insurance is necessary to obtain healthcare. In most of the country, the large and hard-working undocumented immigrant population has no access to health insurance.
Healthcare should not be based on race, gender, nationality, or income. Unfortunately, these distinctions do affect how a person experiences the healthcare system in the United States. The group that I am going to discuss is undocumented immigrants who have faced consequences when trying to get necessary healthcare. Every year, undocumented immigrants file taxes, but they cannot access the services that their tax dollars fund.
A 2022 report from the Institute on Taxation and Economic Policy (ITEP) shows that 11 million undocumented immigrants contributed $96.7 billion in federal, state, and local taxes. This includes $25.7 billion for Social Security, $6.4 billion for Medicare, and 1.8 billion for the unemployment insurance program. Despite these contributions, undocumented immigrants are not eligible to receive benefits due to their legal status.
The unfortunate state of our healthcare system hurts everyone and costs everyone more money. Because undocumented immigrants are denied health insurance, they often forgo routine medical appointments, only seeing a doctor when health problems become life-threatening. When this happens, they visit emergency rooms. Emergency rooms are legally required to treat everyone who enters, whether or not they can pay. So, when an undocumented person visits the emergency room and they cannot pay, their treatment ends up being covered by everyone else. This is not only expensive for everyone, but it also does not protect the long-term health and well-being of our immigrant neighbors.
Some states have attempted to provide undocumented immigrants with the health insurance they deserve. California’s program, Medi-Cal, provides coverage for all individuals, regardless of legal status. In 2024, a report by Kristen Hwang, titled “California Expands Health Insurance to All Eligible Undocumented Adults” estimated that more than 700,000 undocumented immigrants between the ages of 26 and 49 will become eligible for Medi-Cal as part of the state’s final expansion of the program, after a long-awaited dream for Californians without legal status.
Immigrants outside of California deserve healthcare, too. I propose building on California’s success by expanding Medicaid to allow states to offer coverage to undocumented immigrants using federal waivers (like the ACA 1332 waiver), state funding, and nonprofit partnerships. This will prove beneficial for everyone, not just immigrants. According to ITEP, “grading work authorization and full healthcare access to undocumented immigrants could raise their total tax contributions to 136.9 billion, a potential 40.2 billion increase.” This is enough to justify investments in inclusive healthcare. In 40 states, undocumented immigrants pay higher effective state and local tax rates than the wealthiest 1% of earners. It is time that policies reflect this reality.
Lawmakers should look to California’s success and vote to expand Medicaid to undocumented immigrants nationwide. Medi-Cal has been effective in improving individual health, strengthening communities, and reducing the overall burden on the state’s healthcare system. Expansion to ensure comprehensive coverage regardless of immigration status would improve health outcomes, reduce costs associated with emergency room visits, and create justice in the healthcare system. Everyone who pays into the system should have access to the healthcare system.
