Did the health care of immigrants illegally in the country cost Florida taxpayers $566 million?

Florida taxpayers are spending millions of dollars to cover the health care costs of people in the U.S. illegally, Rep. Greg Steube, R-Fla., said on X.

Immigrants in the country illegally cost "Florida taxpayers $566 million for 54,000 hospital visits," Steube said in an April 14 post. "Biden's open border policies make every state a border state, burdening taxpayers with the costs of non-citizen healthcare." 

Is Steube right about that cost in Florida?

Steube’s office said his number comes from Florida’s Agency for Health Care Administration. In March the agency issued two reports, one for state legislators and one for the public, detailing the "Cost of Uncompensated Care for Illegal Immigrants." The legislative report included more analysis and caveats than the public report.

The agency said in a press release that hospital admissions and emergency visits data collected from June to December 2023 showed that in Florida, care provided to people in the country illegally cost more than $566 million. But that doesn’t mean taxpayers paid that entire amount.

The agency’s legislative report said it’s unclear how much of the $566 million was uncompensated.

People in the country illegally can have private insurance or pay for their health care out of pocket. Some also pay taxes, and therefore would be among the taxpayers covering the costs. 

"Rep. Steube is vehemently opposed to illegal immigration and any strain it wrongly places on taxpaying American citizens," Sadie Thorman, Steube’s communications director, told PolitiFact. 

Gov. Ron DeSantis in May 2023 signed into law a bill requiring Florida’s Medicaid-accepting hospitals to ask patients their immigration status. Patients do not have to answer. (About 7% did not answer for the time period covered in the report.)

The law tasked Florida’s Agency for Health Care Administration with an annual report on the total number of hospital and emergency department admissions of people who are in the country lawfully and unlawfully. The report also had to include the costs of uncompensated care for immigrants in the country illegally — how much of their care wasn’t covered by Medicare, Medicaid, private insurance or self-pay.

The agency’s reports said that from June 2023 to December 2023, 0.82% of patients who responded said they were in the U.S. illegally. The agency multiplied that 0.82% by $69 billion — which represents the state’s hospitals total expenditures in 2022, and concluded that Florida provided $566 million in care to immigrants unlawfully in the U.S. 

We reached out to Florida’s Agency for Health Care Administration for more information but did not get a response.

The Florida Policy Institute, a center-left think tank, said that the $566 million is inflated.

The state agency’s report was designed to "estimate how much immigrants cost the state, particularly in uncompensated care," Alexis Tsoukalas, Florida Policy Institute policy analyst told PolitiFact. Therefore, the state agency should have focused on hospitals’ uncompensated care costs, not total expenses, she said.

Featured Fact-check

Ron DeSantis

stated on April 23, 2024 in a news conference

Florida’s Amendment 4 "will mandate abortion until the moment of birth.”

Operating expenses include fixed categories, such as rent, that are not affected by patients’ citizenship status, the Florida Policy Institute’s report said.

A "more measured estimate" would be $21.3 million, the institute said, even though that still doesn’t account for care that was paid out of pocket or through private insurance. To reach this figure, the Florida Policy Institute multiplied the 0.82% of patients who said they were in the U.S. illegally by the total cost of uncompensated care provided by Florida hospitals in 2022 — $2.6 billion. 

Health care experts told PolitiFact that claiming taxpayers had to cover $566 million of care expenses figures that immigrants in the U.S. illegally didn’t pay for any part of their care via private insurance or self-pay. 

Immigrants in the U.S. illegally are ineligible for federally funded programs such as Medicare, but they can have private insurance through employers or can pay for care out of pocket. 

Steube’s claim also figures that all uncompensated care for Florida’s immigrants who are in the U.S. illegally falls entirely on the state’s taxpayers. In emergency cases, hospitals must provide care despite a patient’s insurance coverage or immigration status. That care is covered by federal and state programs. 

In fiscal year 2022 (October 2021 to September 2022), Florida reported to the federal government that it spent $170 million in emergency care for immigrants in the U.S. illegally. The federal government covered $114 million.

When people pay federal and state taxes, those funds help cover the uncompensated care. But many immigrants in the U.S. illegally are among these taxpayers. In Florida, they paid $37 billion in federal, state and local taxes in 2021, according to the latest data available from the American Immigration Council, an immigrant-rights advocacy group.

Several studies have found that immigrants in the U.S. illegally overall give more to the health care system than they take. Their tax payments help fund Medicare, for example, but they are ineligible for it.

Many of the immigrants who enter the U.S. illegally are young and healthy, so they don’t often seek health care services, a 2022 study published in the Journal of the American Medical Association said. The study also said immigrants in the country illegally are less likely to go seek medical services because they don’t always speak English or understand the U.S. health care system.

In its legislative report, the Florida agency said it found no correlation between the amount of uncompensated care at a hospital and the share of immigrants in the U.S. illegally it served. High levels of uncompensated care were associated more with rural hospitals than patients’ immigration status. 

Steube said  immigrants in the country illegally cost "Florida taxpayers $566 million for 54,000 hospital visits."

Steube’s claim contains an element of truth, a Florida agency said hospitals provided $566 million in health care to immigrants in the U.S. illegally. 

But his statement also ignores critical facts that would give a different impression. The agency said it’s unclear how much of the $566 million was uncompensated. It’s possible that some of this cost was covered by migrants who paid for their care out of pocket or via private insurance. Steube’s claim also omits that some immigrants are among the taxpayers helping cover these expenses. And, some experts say that the agency's methodology — calculating the operating costs instead of uncompensated costs — may have inflated the estimate.

Although it’s difficult to say how much precisely the care of immigrants in the country illegally cost Florida taxpayers, Steube’s presentation of the agency’s figures is misleading.

We rate it Mostly False.