Immigrants in Arizona Fiscal and Economic Impacts

Numerous national studies have indicated that, across the board, immigrants use health
care at lower rates than do native-born people. 3 This suggests that the estimated health
care costs in this report may be overstated. However, in light of the sensitivities that exist
about the fiscal costs of immigrants, we have taken a conservative approach by basing our
calculations by assuming similar use of health care by immigrants and native-born persons.
With this approach, we are confident that these costs are not likely to be underestimated.
How were uncompensated care costs of hospitals estimated?
The ACS provides data on access to insurance by nativity and by type of insurance.
The Arizona Department of Health Services (ADHS) publishes annual reports for all
hospitals in the state. These reports include data on bad debt, which we use as a proxy for
uncompensated care costs. Working with the ACS data and the ADHS data, we were able to
arrive at estimates of immigrants’ impacts on uncompensated care costs in Arizona.
The analysis included the following steps:
o
o
o
With 2004 ACS insurance data for Arizona, we calculated the number of nativeborn
persons, naturalized citizens, and non-citizens who were uninsured in 2004.
These numbers were then used to calculate the percentages of uninsured Arizonans
who were native born, naturalized citizens, and non-citizens.
These percentages were then applied to 2004 hospital bad debt data as reported by
the ADHS. These data are reported by hospital, allowing for aggregation to county
and state levels.
The results of this analysis, depicted in Figure 8 and Table 6, are presented by nativity to
illustrate naturalized citizens’ and non-citizens’ impacts on uncompensated care costs
relative to those of native-born persons.
3. See Udall Center Immigration Policy Fact Sheet No. 2, “Immigrants and Health Care” (http://udallcenter.arizona.
edu/immigrationpolicy).
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