title: Unauthorized Immigrants Prolong the Life of Medicare's Trust Fund.
abstract: OBJECTIVE
  Unauthorized immigrants seldom have access to public health insurance programs such as Medicare Part A, which pays hospitals and other health facilities and is funded through the Medicare Trust Fund.
  
  
  METHODS
  We tabulated annual and total Trust Fund contributions and withdrawals by unauthorized immigrants (i.e., outlays on their behalf) from 2000 to 2011 using the Current Population Survey and Medical Expenditure Panel Surveys. We estimated when the Trust Fund would be depleted if unauthorized immigrants had neither contributed to it nor withdrawn from it. We estimated Trust Fund surpluses by unauthorized immigrants if 10 % were to become authorized annually over the subsequent 7 years.
  
  
  RESULTS
  From 2000 to 2011, unauthorized immigrants contributed $2.2 to $3.8 billion more than they withdrew annually (a total surplus of $35.1 billion). Had unauthorized immigrants neither contributed to nor withdrawn from the Trust Fund during those 11 years, it would become insolvent in 2029-1 year earlier than currently predicted. If 10 % of unauthorized immigrants became authorized annually for the subsequent 7 years, Trust Fund surpluses contributed by unauthorized immigrants would total $45.7 billion.
  
  
  CONCLUSIONS
  Unauthorized immigrants have prolonged the life of the Medicare Trust Fund. Policies that curtail the influx of unauthorized immigrants may accelerate the Trust Fund's depletion.
authors.affiliation: Institute for Community Health, 350 Main Street, Malden, MA, 02148, USA. lzallman@challiance.org.|Harvard Medical School, Boston, MA, USA. lzallman@challiance.org.|Cambridge Health Alliance Department of Medicine, Cambridge, MA, USA. lzallman@challiance.org.
authors.forename: Leah
authors.initials: L
authors.lastname: Zallman
authors.affiliation: College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Wilson
authors.affiliation: City University of New York, School of Public Health at Hunter College, New York, NY, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Stimpson
authors.affiliation: Institute for Community Health, 350 Main Street, Malden, MA, 02148, USA. abearse@challiance.org.
authors.forename: Adriana
authors.initials: A
authors.lastname: Bearse
authors.affiliation: Institute for Community Health, 350 Main Street, Malden, MA, 02148, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Arsenault
authors.affiliation: Institute for Community Health, 350 Main Street, Malden, MA, 02148, USA.
authors.forename: Blessing
authors.initials: B
authors.lastname: Dube
authors.affiliation: Harvard Medical School, Boston, MA, USA.|City University of New York, School of Public Health at Hunter College, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Himmelstein
authors.affiliation: Harvard Medical School, Boston, MA, USA.|City University of New York, School of Public Health at Hunter College, New York, NY, USA.
authors.forename: Steffie
authors.initials: S
authors.lastname: Woolhandler
mesh_terms: D005376:Financial Management / Q000191:economics*; D005102:Health Expenditures / Q000331:legislation & jurisprudence*; D006302:Health Services Research; D006801:Humans; D006278:Medicare / Q000191:economics / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D035502:Trust; D000069756:Undocumented Immigrants / Q000706:statistics & numerical data*; D014481:United States
keywords: health care financing; immigrants; medicare