Fact check: What are the estimated annual healthcare costs for undocumented immigrants in the US as of 2025?

1. Why you won’t find a single dollar amount — the data problem that stops an estimate cold

Multiple recent analyses emphasize that the core obstacle is missing, inconsistent data on undocumented population size, demographics, insurance status, and health utilization patterns, which makes national extrapolation unreliable. A September 2024 report introduced a web-based estimation tool while cautioning that outputs are imprecise because of these gaps; the report explicitly states results are indicative rather than definitive ^[1]. Similarly, a 2023 JAMA Network Open analysis examined insurance effects on expenditures but did not—and could not—derive a specific undocumented-immigrant annual cost, underscoring methodological limits when immigration status is not well captured in health expenditure datasets ^[2]. The concordant message across sources is that uncertainty, not consensus, defines current numeric claims.

2. Local models and policy simulations — useful but nontransferable to the nation

Some research produces credible regional or state-level estimates and simulations that illuminate trade-offs but cannot be scaled directly to a US total without strong assumptions. Connecticut-focused modeling from early 2025 assessed the fiscal impacts of expanding coverage for noncitizen populations and provided state-level cost implications, showing how policy design dramatically alters state expenditures ^[4]. The study’s authors note that outcomes depend on the population counted, the services covered, and whether preventive care reduces later emergency spending. These nuances show why state-by-state models are informative policy tools but inadequate as a straightforward path to a single national annual cost figure.

3. Topic-specific cost evidence: cancer and emergency care paint uneven pictures

Specialized reviews reveal high variability in per-person and system costs across clinical contexts, undermining a single aggregated estimate. A 2025 Lancet Oncology review documents barriers and financing strategies for undocumented people with cancer, describing mechanisms such as Emergency Medicaid and Marketplace workarounds, but it does not quantify annual aggregate spending for the population ^[3]. A 2024 scoping review of emergency healthcare access similarly details financial and access barriers but stops short of assigning an overall price tag to care for undocumented patients ^[5]. These focused studies indicate service-specific cost pressures without offering a reliable national sum.

4. Contrasting evidence about immigrants’ fiscal contributions versus costs

Some literature frames immigrant population impacts in terms of net fiscal contributions rather than direct care costs. A 2022 analysis cited here reported that immigrants contributed roughly $115.2 billion more to the Medicare Trust Fund than they withdrew during 2002–2009, a long-range accounting perspective that differs from annual care-cost accounting ^[6]. This framing can be used to argue that immigrants, broadly defined, are net contributors to certain trust funds, but the study does not disaggregate undocumented immigrants’ direct annual healthcare consumption or reconcile differences between trust-fund flows and healthcare expenditures. This contrast highlights different analytic lenses—contribution vs. cost—producing different policy narratives.

5. What each recent source can and cannot tell us — a quick source-by-source reality check

The September 2024 web-tool report offers a methodological advance for scenario modeling but explicitly warns about imprecision ^[1]. The 2023 JAMA article provides robust methods for comparing insured expenditures across nativity but lacks undocumented-status estimates ^[2]. The 2025 Lancet Oncology review and 2024 emergency-care scoping review illuminate clinical and access barriers without costing aggregates ^{[3] [5]}. The Connecticut simulation gives concrete state-level fiscal impacts for policy design but not a national tally ^[4]. In short, each source supplies partial insight, not a national sum.

6. How agendas shape interpretations — watch the framing

Different stakeholders use these partial findings in distinct ways: policy advocates may cite state-model savings or improved preventive-care offsets to support expansion, while opponents may emphasize uncertainties to resist federal spending. The 2022 Medicare-contribution framing can be mobilized to argue immigrants offset costs, whereas specialty reviews on cancer or emergency care may be used to underscore uncompensated-care burdens. Because each source is selective by design, readers should treat claims about “total national costs” as potentially agenda-driven unless they rest on transparent, reproducible national accounting that the current literature lacks ^{[6] [3] [4]}.

7. Bottom line and what would be needed for a credible national estimate

As of 2025, the literature assembled here does not provide a defensible national annual healthcare cost estimate for undocumented immigrants; instead it offers tools, state models, and clinical cost studies that could be combined under strict, transparent assumptions to produce a range. Achieving a credible national figure would require harmonized demographic estimates of the undocumented population, systematic capture of immigration status in medical expenditure surveys, and consistent accounting of public and private spending—data elements the current studies identify as missing or unreliable ^{[1] [2] [4]}. Until those pieces exist, any single-dollar national claim remains speculative rather than evidence-based.