Study: California’s undocumented use fewer health services than US citizens

PHOTO BY K. HARDY

• Emergency room use half that of US citizens

• Hesitant to use hospitals until they are really sick

• Agriculture and construction sectors heavily on undocumented

• Bill would give poorest health care coverage

SAN FRANCISCO, California — Contrary to the drumbeat of criticism that undocumented Americans are a drain on the economy for overusing hospital emergency rooms, a new study released this week found that their rate of emergency room utilization is half that of US citizens.

“Most people who go to the emergency room have insurance and are not worried about providing documents,” noted the study’s lead author, Nadereh Pourat, director of research at the UCLA Center for Health Policy Research. “The undocumented who end up in the emergency room have often delayed getting any care until they are critically sick.”

Researchers also found that undocumented immigrants’ average number of doctor visits was lower: 2.3 for children and 1.7 for adults, compared with 2.8 visits for U.S.-born children and 3.2 for adults.

The study analyzed data gathered in the state in 2009 and 2010 by the California Health Interview Survey (CHIS). It was done in multiple languages and in a “culturally competent” manner, Pourat said. More recent data from CHIS indicates that not much has changed in the characteristics of the state’s population, she said.

The release of the study comes at a time when California lawmakers are debating whether they should extend health care access to an estimated one million of the state’s undocumented residents who have no insurance. The 2010 Affordable Care Act disqualifies them from any of the federal law’s benefits.

Introduced earlier this year by Sen. Ricardo Lara (D-Long Beach), the Health for All Act, which to date has 16 co-sponsors, would use state dollars to pay for Medi-Cal coverage for low-income undocumented residents. It would also establish an online marketplace where undocumented immigrants with higher incomes could buy private insurance. It is currently in the Senate appropriations committee.

CHIS data found that in 2009, the state had 2.2 million undocumented immigrants. And while they made up 6.8 percent of California residents, they represent nearly a quarter of the state’s uninsured population.

Undocumented Californians are a vital part of the state’s population and economy, working in physically demanding jobs such as in construction and agriculture, said Pourat. The estimated annual tax contributions of undocumented immigrants in California is $2.7 billion and 92 percent of this population live in working families, Lara said in a statement when he introduced the bill.

Pourat observed that even if Lara’s bill fails, “it starts a conversation we should be having” about the importance of providing health care for all of the state’s residents.

“By leaving a huge percentage of the population without coverage, we end up spending more,” she said.

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