More on Budgeting

Care costs for undocumented immigrants absorbed by hospitals

Hospitals lump such costs into bad debt

Since undocumented immigrants can’t participate in the healthcare insurance exchanges created by the Affordable Care Act, millions of foreign-born residents will be excluded, leaving hospitals to continue to pick up the cost of their care.

According to Pew Research, there are approximately 10.5 million undocumented immigrants in the U.S. The current cost of treating uninsured undocumented immigrants, primarily at emergency rooms and free clinics, is estimated at $4.3 billion annually, according to the Center for Immigration Studies.

[See also: A study finds that immigrants pay more into Medicare than they consume]

The unreimbursed cost of providing care for all uninsured or underinsured patiets totaled a record-high $41.1 billion in 2011, according to the American Hospital Association.

In California alone, where approximately 2.5 million residents are undocumented immigrants, the annual cost of unpaid hospital care is between $1 billion and $1.5 billion estimates the Hospital Association of Southern California.

But calculating the cost of care given to undocumented immigrants is challenging because most hospitals don’t ask about citizenship, said Jan Emerson-Shea, the California Hospital Association’s vice president external affairs. Since they don’t ask about citizenship, most hospitals do not track how much it is costing them to care for that cohort of the population.

Instead, said Danny Chun, a spokesman for the Illinois Hospital Association, those costs are lumped into bad debt.

[See also: Stopping the rise in hospital bad debt]

“For accounting purposes, if a person does not provide financial information and it turns out they can’t pay, that is accounted for as bad debt,” said Chun. Knowing if a patient who can’t pay for care is or is not an undocumented immigrant doesn’t really matter, Chun said, “because hospitals are absorbing the cost.”