Fact check: What is the average healthcare expenditure per undocumented immigrant in the US as of 2025?

1. Claims on the table that grab headlines — low per-person cost versus immigrant averages

Several discrete claims appear across analyses: a July 2025 study estimates the average annual healthcare expenditure per undocumented immigrant at $1,629, notably below the figures for documented immigrants ($3,795) and U.S.-born persons ($6,088) reported in that same work ^[1]. Other reputable summaries calculate average expenditures for the broader immigrant population (including naturalized citizens and documented noncitizens) at $4,875 per person, about two-thirds the $7,277 average for U.S.-born residents — but these immigrant figures do not isolate undocumented persons ^{[2] [3]}. Separately, analyses of public program spending show that emergency Medicaid payments for noncitizen emergencies were $3.8 billion in FY2023 and represent less than 1% of total Medicaid spending, a programmatic measure that cannot be translated directly into a per-undocumented-person annual cost without additional assumptions ^[4]. Each claim is factual in context, yet they spotlight different slices of spending and different populations.

2. Why methods explain the gaps — different denominators, services, and datasets

Discrepancies arise because researchers use different denominators (all immigrants, documented subgroups, undocumented-only estimates) and different baskets of services (total utilization across private and public payers versus emergency-only public spending). The immigrant-average studies rely on national expenditure surveys that aggregate all immigrant subgroups and thus inflate per-capita estimates relative to a population subset that may use less care. The emergency Medicaid figures capture only program payments for emergent hospital care for noncitizens, intentionally excluding outpatient, privately paid, or uncompensated care — producing a tiny share of aggregate Medicaid spending but offering no direct per-person average for undocumented immigrants ^{[2] [4] [3]}. The $1,629 estimate is a study-level per-person figure focused on undocumented immigrants, but its comparability depends on sampling, imputation of status, and which payers and services were counted ^[1].

3. What JAMA’s emergency Medicaid findings add — a narrow but revealing fiscal slice

Recent JAMA analyses situate emergency Medicaid spending for undocumented immigrants as a small fraction of Medicaid outlays: one set of findings reports emergency Medicaid constituted 0.4% of total Medicaid expenditures in 2022, with average per-resident emergency costs near $9.63–$10 depending on the analytic frame ^{[5] [6] [7]}. These figures illuminate how limited programmatically reimbursed emergency care is relative to overall Medicaid budgets, and they underscore that publicly tracked emergency payments are not a proxy for total health consumption or total costs endured by undocumented individuals. Emergency Medicaid’s share can rise in states with larger undocumented populations — to about 0.9% in some state-level analyses — but even that elevated share remains a specialized metric that should not be interpreted as total per-person healthcare spending ^{[7] [4]}.

4. The single-study $1,629 estimate — useful but bounded by limitations

The July 2025 study claiming $1,629 per undocumented immigrant provides the most direct single-number estimate for that population ^[1]. Its strength lies in explicitly attempting to isolate undocumented status and compute per-person annual expenditures. Its limitations stem from the common challenges of identifying undocumented individuals in survey or administrative data, potential undercounting of uncompensated care, and choices about whether to include out-of-pocket, private, and charitable services. The figure also contrasts sharply with broader immigrant averages, signaling either true lower utilization by undocumented people or methodological differences—such as different sample frames, imputation techniques for legal status, or exclusion of certain cost categories — that materially affect outcomes. The $1,629 number should be treated as a study-specific estimate rather than a definitive national average without corroborating multi-source validation ^{[1] [2]}.

5. The big picture and what’s missing — access, barriers, and state variation change the story

Taken together, the analyses consistently show undocumented and immigrant populations use less healthcare and generate lower expenditures than U.S.-born residents, but they also reveal large omitted considerations: access barriers, high uninsured rates, deferred care that produces uncompensated costs, and substantial state-by-state policy variation that shifts costs between public programs, hospitals, and private payers. Emergency Medicaid captures a tiny public payment stream but misses outpatient, community clinic, and uncompensated emergency department care that often falls to providers or is financed indirectly. State policy differences and local safety-net capacity can double or halve observed programmatic spending patterns, so national averages obscure critical heterogeneity ^{[3] [4] [7]}.

6. Bottom line: no single authoritative 2025 per-capita number — use ranges and context

There is no single authoritative national per-capita healthcare expenditure for undocumented immigrants in 2025 that all data can validate. A recent study gives a focused estimate around $1,629 per year for undocumented individuals, while broader immigrant averages are $4,875 and U.S.-born averages $7,277, and emergency Medicaid spending for noncitizens remains a very small share of Medicaid budgets ^{[1] [2] [4]}. For policy or