“If you believe in universal health care, you believe in universal health care,” California Governor Gavin Newsom said in support of efforts to expand health care benefits for undocumented immigrants in the state, and on January 1, that became a reality. Thousands of young undocumented people in California are now able to access the state’s Medicaid program.
California has provided health benefits to undocumented minors under 18 since 2016. Now Medi-Cal will extend to young, low-income adults until they turn 26. Officials secured $98 million to expand the coverage for the estimated 138,000 undocumented adults who are now eligible for full-scope benefits under Medi-Cal.
An estimated 2.2 million undocumented immigrants live in California. Undocumented immigrants in most states are ineligible for federal health benefits like Medicaid, despite paying billions of dollars into them annually. During President Trump’s first address to Congress in January 2017, he falsely claimed that undocumented immigrants cost the country “billions a year.” But the numbers from government agencies paint a very different reality: IRS data shows that undocumented immigrants pay billions in payroll taxes annually. But how?
In 1996, the IRS created Individual Tax Identification Numbers, or ITINs, to replace Social Security Numbers for undocumented individuals to be able to pay taxes. ITINs aren’t used to grant immigration status or work authorization, but undocumented workers often obtain them to use in support of immigration petitions and applications for citizenship.
In 2015, over 4.4 million ITIN filers paid $23.6 billion in total taxes. Those filers also contributed over $5.5 billion in payroll taxes that year. Undocumented immigrants, just like everyone else who receives a paycheck, pay into federal benefits like Medicaid and Social Security via these taxes — benefits that they can’t even access without a Social Security Number. In a 2013 review of Social Security benefits, the administration found that undocumented workers contributed a whopping $13 billion in one year — a substantial contribution to note as concerns over the program’s solvency loom large for future generations.
“We estimate that earnings by unauthorized immigrants result in a net positive effect on Social Security financial status generally,” chief actuary of the Social Security Administration, Stephen Goss said of the report.
Undocumented immigrants are technically eligible for just emergency services through Medicaid, but many avoid hospitals due to fear of ICE and deportation. And similarly to uninsured people with citizenship, many without resources or access to health care either forego treatment entirely or end up in emergency rooms with critical conditions, where costs are tripled for both the individual and local & state services.
Often undocumented immigrants and families who need regular care for things like kidney dialysis visit emergency rooms on a cyclical basis. Dr. Lilia Cervantes treated one undocumented woman for emergency dialysis over the course of three years in a Denver hospital. The woman decided to stop treatment due to the stress it caused her and her family. She died shortly after.
“It’s very, very distressing. We not only see the suffering in patients, but also in their families,” Cervantes told NBC. “Clinicians are physically and emotionally exhausted from this type of care. I practically had to take a class in immigration to understand what’s going on. Physicians just don’t understand it, and we shouldn’t have to.”
