BUFFALO, N.Y. -- With health care, the national deficit and
immigration all serving as current hot-button political issues, one
University at Buffalo professor has found a viable way to both save
money and provide health care for elderly immigrants.
Simply make elderly immigrants eligible for Medicaid.
Yunju Nam, an assistant professor at the UB School of Social
Work, recently completed a study that found it is more expensive
for the country to restrict immigrants' access to Medicaid than it
would be to allow them the benefits.
Nam research looked into how the Personal Responsibility and
Work Opportunity Reconciliation Act of 1996 (commonly known as
"welfare reform") affected health care coverage among a nationally
representative sample of adults 65 years of age or older.
Because of welfare reform, non-citizens are no longer eligible
for federally funded Medicaid if they immigrated to the United
States after 1996 and have not lived in the country for five years
or longer. For example, under welfare reform, a 75-year-old woman
who emigrated from Poland to the U.S. four years ago, and is unable
to afford health care on her own, would be ineligible to receive
According to Nam, these toughened federal eligibility
requirements created by welfare reform resulted in a drop in the
number of elderly immigrants covered by Medicaid, indicating it had
become harder for non-citizens to gain access to health care. This
caused an increase in emergency room Medicaid expenditures for
older immigrant adults, as many of them were not able to afford
preventative health care on their own.
Also, the number of naturalized citizens covered by Medicaid
increased after welfare reform, showing that those immigrants who
were still eligible had gained citizenship specifically to receive
health care coverage.
"Because better coverage for citizens would've been incentive
for immigrants to naturalize, cost-savings that may have been
realized from decreased Medicaid coverage among older non-citizens
was likely offset by increased coverage for older naturalized
citizens," says Nam.
Nam's research is expected to be published by the end of the
year in the Journal of Aging and Health.
Unfortunately, many elderly non-citizens, even those eligible
for naturalized citizenship, voluntarily withdraw from
public-benefit programs, such as Medicaid, out of fear of potential
disadvantages, Nam says.
"They are afraid that they would not be able to sponsor their
family members' immigration to the U.S. or that they might be
deported if they received public benefits," he adds. "Approximately
40 percent of immigrants in New York City and Los Angeles think
that welfare recipients are not eligible for naturalization."
Nam believes the federal government should reach out to
low-income elderly immigrants and educate them about the realities
of receiving public assistance to help them overcome their fears.
"Let them know that participation in Medicaid will not affect their
eligibility for naturalization or their ability to sponsor the
immigration of family members to the U.S.," Nam says.
Previous studies have shown that a lack of health coverage
limits an individual's access to both preventative and needed
medical care, resulting in increased emergency room services and
higher long-term costs to society. Since Medicaid is the only way
for many of these elderly immigrants to keep themselves healthy and
out of emergency rooms, Nam drew the conclusion that making access
to Medicaid easier would cost society less than denying them health
"Restricting older immigrants' Medicaid coverage likely raises
long-term health care costs even if it were to succeed in excluding
immigrants from Medicaid coverage in the short-term," Nam says.
"Given this study's findings and other empirical evidence on the
negative consequences of limited access to medical care,
policymakers should reconsider the current policy of restricting
Medicaid eligibility of noncitizens."
The University at Buffalo is a premier research-intensive
public university, a flagship institution in the State University
of New York system and its largest and most comprehensive campus.
UB's more than 28,000 students pursue their academic interests
through more than 300 undergraduate, graduate and professional
degree programs. Founded in 1846, the University at Buffalo is a
member of the Association of American Universities.