Health and health care for undocumented immigrants in the United States: A review of the literature

Background: The 11.2 million undocumented immigrants living and working in the US will be excluded from receiving health insurance coverage through the Affordable Care Act (ACA).

Objectives: To identify current research on health status, healthcare access and costs of care for undocumented immigrants in the United States.

Methods: Searches were completed via Medline and LexusNexus in addition to a general web search for foundation reports and policy briefs. Articles were divided broadly into topics of health status, access to care and costs of health care, with subgroups specified within each broad topic (e.g. child health, chronic disease).

Results: Undocumented immigrants may enjoy a relative health advantage. However, this advantage rapidly deteriorates as undocumented immigrants receive less adequate healthcare than any other group, including preventive care. In many cases, like prenatal care, the adverse effects of poor access to care are passed on to US-born children of undocumented parents. In turn safety net providers must shoulder the costs of increased complications (e.g. during the postnatal period), which may have been avoided with improved preventive care. Gaps in the literature include information on chronic disease, and how poor health care access exacerbates chronic disease. There is also little knowledge about how the effects of poor healthcare access will accumulate for undocumented immigrants and their children across the life-course.

Conclusions: Undocumented immigrants will likely continue to have poor access to health care under ACA; this may in turn contribute to adverse and costly health outcomes for undocumented immigrants and their children.