Fact check: What are the estimated healthcare costs for illegal immigrants in the US in 2024?

1. What people are claiming — and what the evidence actually states

Multiple claims purporting to quantify healthcare costs for “illegal” or undocumented immigrants in 2024 rely instead on indirect estimates or older per‑person figures rather than a comprehensive national total. Researchers emphasize that no recent study provides a definitive 2024 national cost for undocumented immigrants; RAND and other summaries explicitly note the challenge of producing a single figure because of data gaps on population size, demographics, and utilization ^[1]. Older per‑person estimates from academic work and KFF analyses are often reused in public debate, but those figures are not equivalent to a current national aggregate and are based on earlier datasets and different definitions of immigration status ^{[2] [3]}. The juxtaposition of these materials explains why public claims range from modest tens of billions to speculative hundreds of billions—differences driven by incompatible inputs rather than new 2024 measurement.

2. The strongest empirical building blocks — per‑person spending and utilization gaps

Peer‑reviewed and policy analyses offer more reliable comparisons at the per‑person level than at the aggregate level. A multi‑year academic study estimated annual expenditures for unauthorized immigrants at roughly $1,629 per person and for authorized immigrants at $3,795, compared with $6,088 for U.S.‑born individuals, showing substantially lower per‑capita health spending among immigrants ^[2]. KFF’s analysis of 2021 medical expenditure data reached a similar conclusion: immigrants on average incur about two‑thirds the spending of U.S.‑born people ($4,875 vs. $7,277), with lower use across office, inpatient, outpatient, prescription drug, and dental care categories ^[3]. These per‑person patterns are the best empirical inputs currently available for any attempt at aggregation, but they require reliable counts of the undocumented population to scale to national totals—a missing piece emphasized in recent methodological reviews ^[1].

3. State examples show the calculus, not a national truth

State‑level modeling can illustrate fiscal impacts of coverage changes but cannot be extrapolated to a precise national 2024 cost without strong assumptions. A Connecticut analysis modeled the fiscal effect of expanding HUSKY eligibility to noncitizens and projected state cost increases ranging from about $39–40 million for some age groups up to $252 million for all ages under broader expansions, demonstrating how eligibility design and population age structure drive costs ^[4]. These modeled outcomes are useful for policymaking in a single jurisdiction but are not evidence of aggregate national costs for undocumented immigrants in 2024, since states differ in immigrant composition, program rules, and baseline coverage levels ^{[4] [1]}.

4. Macro estimates and extreme scenarios are often misaligned with health spending

Some high‑profile figures discussed in the literature concern related fiscal scenarios—such as deportation costs or large‑scale budgetary effects of immigration flows—but they do not represent routine healthcare spending by undocumented immigrants. A special report estimated the cost of a hypothetical one‑time mass deportation at a minimum of $315 billion, a figure intended to capture operational and indirect costs, not annual medical care expenditures ^[5]. The Congressional Budget Office has produced analyses of immigration’s broad federal budget effects without isolating a 2024 undocumented‑healthcare price tag ^[6]. Conflating these types of estimates with annual healthcare expenditures creates confusion; the available studies caution that different policy questions produce very different numerical comparisons ^{[5] [6]}.

5. Why precise national estimation remains out of reach and what to watch

Research repeatedly identifies three specific obstacles to a trustworthy 2024 national healthcare cost estimate for undocumented immigrants: uncertain population counts, incomplete breakdowns by age and health status, and gaps in utilization data tied to legal status ^[1]. Without improved administrative or survey data on undocumented population size and healthcare use patterns, any aggregate number will depend heavily on contested assumptions. Future improvements would come from updated population estimates, linkage of utilization information to immigration status in anonymized data, and consistent definitions across studies. Until these improvements appear, robust policy analysis should present ranges and sensitivity analyses rather than single‑point national sums ^[1].

6. Bottom line for policymakers and the public

There is no authoritative estimate of total healthcare costs for undocumented immigrants in the U.S. for 2024; the best empirical evidence supports lower per‑capita spending by immigrants than by U.S.‑born residents and shows how state policy design can materially change budgetary impacts at the state level ^{[2] [3] [4]}. Public debate should therefore shift from seeking a single national headline number to focusing on transparent modeling choices, improved data collection, and targeted analyses of policy options—because the magnitude of costs depends more on legal access, program rules, and population composition than on a mysterious fixed total ^[1].