Fact check: What is the average annual cost of providing healthcare to an undocumented immigrant in the US?

1. Why simple averages mislead — different questions, different numbers

Studies cited in the analyses address distinct questions: individual total healthcare expenditures, public-sector outlays, and system-wide net fiscal contributions. One health-services study found annual per-person expenditures of $1,629 for unauthorized immigrants, $3,795 for authorized immigrants, and $6,088 for U.S.-born individuals, reflecting utilization patterns and insurance access rather than the public cost of providing care ^[1]. By contrast, a 2013 analysis reported that unauthorized immigrants received about $140 annually in public-sector healthcare spending, a much smaller figure because it excludes privately paid care and emergency-only access ^[2]. These measures answer different policy debates and yield different “averages.”

2. Net fiscal/subsidy framing flips the question

Analyses that estimate contributions versus receipts find a different story: immigrants overall, and undocumented immigrants in particular, have been estimated to contribute more in premiums and taxes than they consume through third-party payers, producing a net surplus for health financing in one recent assessment ^{[4] [5]}. That frame aggregates payroll taxes, premiums, and government outlays to produce a net figure; it does not provide a direct per-person “cost to provide care” number, but it underscores that public-budget impact can be small or even positive while utilization-based averages remain lower.

3. Policy scenarios produce much higher headline costs

When analysts model what would happen if undocumented immigrants gained access to federally funded programs, reported aggregates shift. One analysis provided a projection of roughly $10 billion per year if unauthorized immigrants were allowed into federal programs — an estimate that depends on enrollment assumptions, benefit packages, and whether previously uncompensated emergency care shifts into regular care settings ^[3]. Scenario-driven totals are sensitive to policy design and do not equate to a per-capita “average” without clear assumptions about uptake, benefit levels, and substitution of current uncompensated care.

4. Recent state-policy work adds complexity but not a single number

A 2025 state-focused review highlights that states vary widely in coverage for noncitizens and in state-funded programs that alter who is in the safety net, but it does not report a single per-unauthorized-immigrant annual cost. The review emphasizes heterogeneous access and fiscal impacts across states, meaning national averages mask important local differences driven by state policy choices and immigrant population mixes ^[4]. State expansions can increase per-capita public spending in program recipients while also improving preventive care and potentially reducing costly emergency use.

5. Historical public-expenditure figures emphasize low public receipts

Older analyses find unauthorized immigrants account for a small share of total healthcare spending. For example, studies reported unauthorized immigrants’ healthcare spending share as $15.4 billion, and that just 7.9% accessed public-sector healthcare, yielding roughly $140 per person per year in public spending — figures that reflect limited eligibility and barriers to enrollment ^[2]. Those numbers are consistent across multiple analyses showing low per-capita public outlays, but they predate and do not capture recent local policy expansions or pandemic-era changes.

6. What policymakers and the public often miss: utilization, access, and substitution effects

Low average spending per unauthorized immigrant reflects reduced access to primary and preventive care, greater reliance on emergency departments, and lower rates of insurance. These dynamics mean per-person spending is suppressed relative to U.S.-born populations; however, expanding access can raise measured per-person public costs while potentially lowering high-cost emergency and inpatient episodes. Cost comparisons should include both short-term programmatic costs and longer-term substitution effects to evaluate net fiscal outcomes ^{[1] [3] [4]}.

7. Bottom line for someone asking “what is the average annual cost?”

If the question seeks total healthcare spending per person, the best available estimates place annual expenditures for unauthorized immigrants near $1,600 per person, substantially below U.S.-born averages. If the question asks about public spending per unauthorized immigrant, studies report figures near $140 per person annually. If the question concerns budgetary impact under expanded access, scenario estimates climb into the billions nationally depending on assumptions ^{[1] [2] [3] [4]}. Each number is valid for its framing; choose the framing that matches the policy question.