National Data | Sick in the City: Bloomberg on Health Care for Illegals
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When a recent caller to New York City Mayor Michael Bloomberg's weekly radio show complained about the costs of providing health care to illegal immigrants, Hizzoner said it wasn't so. He even added:

"Unfortunately, the undocumented workers [sic] don't avail themselves of services until their situation is dire."

And Bloomberg claimed that illegals eschew medical services for fear of being reported to federal immigration authorities.

This is what New Yorkers call chutzpah. Bloomberg is simply flat-out wrong. Indeed, in September 2003 the Mayor himself issued Executive Order 41 [PDF] highlighting "…a list of services provided and administered by the city that non-U.S. citizens may access regardless of immigration status."

Among the services:

  • Emergency medical care (including ambulance service);


  • Children's Health Insurance (a state program for all children under 19)



  • immunizations



  • "certain services provided by the Department of Health and Mental Hygiene."

EO 41 went on to promise: "If you share your immigration status or other confidential information with City employees, they will not report this information to anyone, except in limited circumstances such as when required by law." [See Bloomberg To Illegals: Make Yourselves At Home, by Michelle Malkin ]

Immigrants in New York City also benefit from New York State's Medicaid program, the largest in the country and notorious for waste and inefficiency, is. At $34 billion per year it is even more expensive than California's system, which covers more than twice as many people. [Medicaid State Data: PDF ]

Medicaid spending per eligible recipient in 2003 was: (Table 1)

  • $4,228 in the U.S.


  • $2,569 in California


  • $8,608 in New York City

It's difficult to gauge the share of Medicaid spending attributable to illegal immigrants. But Joseph Salvo, a prominent New York demographer, estimates that at least 400,000 illegal immigrants live in New York City—about 5 percent of the population. Total NYC Medicaid spending was $22 billion in 2004. So it's not unrealistic to impute $1.1 billion (5 percent of $22 billion) to illegals.

It could be more. Although illegal immigrants are younger than the general population, they are also poorer and less likely to be covered by private employment-based insurance. Their share of Medicaid spending could easily exceed their population share.

More importantly, illegals are the most rapidly growing segment of New York City's immigrant population. Exhibit #1; the striking rise in the city's Mexican immigrant population, which according to census figures went from 32,689 in 1990 to 122,550 in 2000. City demographers say the true growth is probably higher, to 200,000, and is not expected to slow.

Mexicans are now the fifth largest immigrant group in the city, up from 17th in 1990. Births to Mexican-born mothers—6,408 in 2000—are second only to births to immigrant Dominicans—the city's largest immigrant group.

Jeffrey Passel, a demographer with the Pew Hispanic Center who has studied the issue, finds that nationally 80 to 85 percent of Mexican immigration since 1990 was illegal. "Any place that's getting a lot of new immigration from Mexico, virtually all of it is undocumented, and that certainly includes New York," says Passel. [Record Immigration Is Changing the Face of New York's Neighborhoods, By Nina Bernstein, New York Times, January 24, 2005]

Of course, Medicaid costs are defrayed by state and federal funds. There is no local tax support. Politically, therefore, Mayor Bloomberg is insulated. To that extent, he can afford to be generous with other people's money.

But the bottom line: through city, state and federal taxes, New York City residents are indeed subsidizing illegal immigrants' health care.

Contact Mayor Bloomberg

Edwin S. Rubenstein (email him) is President of ESR Research Economic Consultants in Indianapolis.

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