Imagine a child missing school for days, not because of a lack of care, but because their family couldn't afford a doctor. This is the reality for many undocumented immigrants in the U.S. who, despite contributing billions in taxes, are often denied access to basic healthcare.
Last month, as a social work intern, I witnessed this firsthand. A kindergartener in my care was absent for most of the week due to illness. Her mother couldn't take her to a doctor because they lacked both the financial means and Medicaid coverage. The reason? They were undocumented immigrants.
But here's where it gets controversial... In 2022, undocumented immigrants collectively contributed a staggering $96.7 billion in federal, state, and local taxes, according to the Institute on Taxation and Economic Policy. Considering that undocumented immigrants make up only 27% of the total immigrant population, this is a significant contribution.
This means that roughly 14 million people contributed almost $97 billion in taxes, yet often receive little in return. A large portion of that, $59.4 billion, went to federal taxes, with another $37.3 billion going to state and local taxes.
Despite common misconceptions, undocumented immigrants are largely excluded from federal assistance programs due to the 1996 welfare reform law signed by President Bill Clinton. This law restricts access to food stamps, welfare, Medicaid, Medicare, and even Affordable Care Act plans, usually requiring a Social Security number for eligibility. Only 'qualified aliens' are typically eligible for federal public benefits.
And this is the part most people miss... Although they pay substantial taxes, federal law often bars undocumented immigrants from the very programs their tax dollars help fund. The argument for providing them with access to Medicaid, at the very least, is compelling, not only for humanitarian reasons but also for societal benefit.
Currently, they are eligible only for emergency Medicaid, which covers immediate, short-term medical treatments, with some states including care like dialysis and cancer treatments. Even in states with large undocumented immigrant populations, the cost of emergency Medicaid accounts for less than 1% of the state's Medicaid budget.
The Institute on Taxation and Economic Policy also notes that over one-third of the taxes paid by undocumented immigrants goes toward payroll taxes, funding programs they cannot access. In 2022, undocumented immigrants paid $25.7 billion in Social Security taxes, $6.4 billion in Medicare taxes, and $1.8 billion in unemployment insurance taxes. Essentially, they are paying for services they cannot use.
Providing work authorization to all undocumented immigrants could further increase their tax contributions. The Institute suggests that if work authorization were granted, tax contributions could increase by $40.2 billion annually, bringing the total to $136.9 billion. Of this, $33.1 billion would go to the federal government and $7.1 billion to state and local governments.
Here's a thought-provoking question: Should Congress amend the welfare reform law to allow undocumented immigrants access to Medicaid? Doing so could improve their health, leading to a more productive workforce and potentially boosting the economy. Who would benefit from such a change?
It's clear that undocumented immigrant workers, the businesses that employ them, and the economy as a whole stand to gain.
Dustin Hopkins is a Master’s student in Social Work at Fort Hays State University and an elementary school social work intern.
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