A “Refugees Welcome” mat at an immigration rally in New York, City, March 3, 2017. (Carlo Allegri/Reuters)

Health insurance for immigrants could prove a big fault line in 2020. Last week the president announced a plan to keep out many legal immigrants (excepting refugees, etc.) who can’t show that they will be able to cover their medical costs, whether through insurance or out of their own pockets — the idea being that immigrants should support themselves, not rely on our safety net or impose uncompensated-care costs on hospitals. By contrast, many Democrats want to give even illegal immigrants full access to taxpayer-funded health care. The Center for Immigration Studies has an interesting pair of reports today (and an event you can stream on Facebook starting at 9:30 Eastern) on this topic.


One of them assesses the current cost of providing Medicaid to immigrants. It finds that “42 percent of immigrant-headed families had at least one member who was enrolled in Medicaid during 2016, compared to 26 percent of native-headed families. The average immigrant family created $2,796 in Medicaid costs, compared to $1,983 for the average native family.”

Note the focus on “immigrant-headed” families: Many of these include kids and even spouses who were born here and are thus citizens, and therefore will be eligible for more welfare benefits. I think it’s obviously fair to include kids when talking about immigration policy — because they wouldn’t be here if our immigration policy hadn’t let in their parents — but others disagree.

The report continues:

Immigrants are costlier not because they have any special appetite for welfare, but because they tend to have less education and larger families that they struggle to support. All U.S. residents with those characteristics, foreign-born or native-born, are more likely to rely on government programs such as Medicaid. Immigrant welfare use can be reduced by changing selection criteria to favor immigrants who will have sufficient earning power to support their families without taxpayer assistance.

Bingo.

The other report explores the cost of expanding health insurance for illegal immigrants. It estimates that if you made our roughly 4.9 million uninsured, low-income illegal immigrants eligible for Obamacare subsidies, it would cost about $10 billion a year. This works out to about $80 per household in the country — but it might be a bit high, e.g. because it assumes that Obamacare-eligible illegal immigrants would have the same enrollment rate (46 percent) that everyone else has, which strikes me as unlikely, especially because the individual mandate expired this year and the report takes its baseline from last year’s enrollment.

If you want to take your own guess of how many would sign up, multiply it by $4,637 to get the total cost. That’s actually less than the typical native enrollee costs, mainly because illegal immigrants tend to be younger.