Trends in Emergency Medicaid Expenditures for Recent and Undocumented Immigrants

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Abstract
A steady increase in the number of foreign-born adults and children living in the United States has fueled debate about the financial burden new immigrants may place on publicly funded health care, but relatively little is known about the health status and health services use of this population. Undocumented immigrants constitute an increasing proportion of newly arrived individuals, with numbers now estimated to exceed 10 million, or 29% of the total US foreign-born population. This growth is occurring most rapidly in “new-growth” states with previously small immigrant populations,1 placing an increasing proportion of immigrants in communities that may be less prepared to meet their health care needs.2 North Carolina's total foreign-born population grew by 274% during the 1990s,3 and included an estimated 300 000 undocumented immigrants by 2004.1 Despite high employment rates, immigrants face an extraordinary array of barriers to accessing health care including widespread poverty, language and cultural barriers, and lack of health insurance.4,5

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