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Sarita A. Mohanty, MD, MPH, Steffie Woolhandler, MD, MPH, David U. Himmelstein, MD, Susmita Pati, MD, MPH, Olveen Carrasquillo, MD, MPH and David H. Bor, MD

Sarita A. Mohanty is with the Department of Medicine, Division of Geriatric and General Internal Medicine, University of Southern California, Los Angeles. Steffie Woolhandler, David U. Himmelstein, and David H. Bor are with the Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, Mass. Susmita Pati is with The Children’s Hospital of Philadelphia and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia. Olveen Carrasquillo is with the Division of General Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

Correspondence: Requests for reprints should be sent to Sarita A. Mohanty, MD, MPH, Department of Medicine, Division of Geriatric and General Internal Medicine, University of Southern California, 2020 Zonal Ave, IRD 627, Los Angeles, CA 90033 (email: samohant{at}usc.edu).

Objectives. We compared the health care expenditures of immigrants residing in the United States with health care expenditures of US-born persons.

Methods. We used the 1998 Medical Expenditure Panel Survey linked to the 1996–1997 National Health Interview Survey to analyze data on 18398 US-born persons and 2843 immigrants. Using a 2-part regression model, we estimated total health care expenditures, as well as expenditures for emergency department (ED) visits, office-based visits, hospital-based outpatient visits, inpatient visits, and prescription drugs.

Results. Immigrants accounted for $39.5 billion (SE=$4 billion) in health care expenditures. After multivariate adjustment, per capita total health care expenditures of immigrants were 55% lower than those of US-born persons ($1139 vs $2546). Similarly, expenditures for uninsured and publicly insured immigrants were approximately half those of their US-born counterparts. Immigrant children had 74% lower per capita health care expenditures than US-born children. However, ED expenditures were more than 3 times higher for immigrant children than for US-born children.

Conclusions. Health care expenditures are substantially lower for immigrants than for US-born persons. Our study refutes the assumption that immigrants represent a disproportionate financial burden on the US health care system.

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