Fair Q’s - after some googling, this article was the most balanced take I can find on it. It looks like detailed tracking of birth tourism is currently not possible.
Some tl;dr; points from the article
… the assumption that birth tourists do not pay is not uniformly true. There is no comprehensive data on whether birth tourists pay their medical bills, but Jackson Health System in Miami has noted that 72% of international maternity patients pay with insurance or a pre-arranged package. While immigrants are generally poorer than native-born Americans, birth tourists must by definition have adequate economic means to cover travel costs and may, in fact, be well off…Ironically, Trump properties in Miami reportedly serve as some of the most popular maternity hotels.
Furthermore, a 2007 study out of North Carolina demonstrated that while the vast majority of Emergency Medicaid spending in that state was for pregnancy, childbirth, and complications, only 0.8% of all Emergency Medicaid patients were documented immigrants…given that most birth tourists have B-2 tourist visas and would therefore be considered documented, the paper seems to provide little evidence that there were a significant number of birth tourists relying on tax-funded healthcare. While birth tourists tend to foot the bill in routine cases, this trend may be reversed when things go wrong. One study out of Orange County, Calif., found that children of birth tourists admitted to a NICU had longer hospital stays, more surgical procedures, and larger hospital bills than children of non-birth tourists. U.S. taxpayers may, therefore, end up paying for care in some of these complicated cases. (Of note, this study was small – 50 patients – and homogeneous – most in the study were Chinese – limiting the generalizability of these findings.
And to be clear, my original point wasn’t that this is an urgent issue that needs to be solved in the US but that I don’t see the net harm of the birthright citizenship law being changed to something that is more standard abroad. As long the child gets perm residency and a path to citizenship I think I would be open to it (depending on the details) - and it will have a side effect of curtailing some of the practices just discussed above which elicit emotional responses from people who tend to be anti-immigration in general.
This more or less why I’m asking those questions. I’m not directing this at you in particular, but if there is very little evidence that birthright citizenship is causing a problem, then you have to wonder what motivates people who want to ‘solve’ this problem. I mean, it’s hard to solve, and if there’s no real problem anyway, why would someone want to spent energy on it?
Yeah, the whole topic is pointless. One rotten cabinet secretary can do more harm in a single day than the total number of green-card-holders, dreamers, or other non-citizen migrants with US citizen children ever has or will.
Also, too, the fact that there isn’t any data on birth tourism deadbeats suggests that deadbeatism isn’t really a problem. If doctors and hospitals that participate in birth tourism were not making money on it, but actually losing money on it, then they would be lobbying Congress to do away with it to stop the bleeding, and they would be offering statistics on how much money it costs them. But they’re not, so they like it fine, so deadbeatism isn’t a problem.
Wouldn’t most of that cost come out of the federal system in that case?
You could be right, but I don’t think you can point to the lack of detailed statistics as evidence here, since making changes to data collection to get this kind of information accurately also seems to be non-trivial.
Why? Birth tourism is an industry. Most people pay the medical fees up front as part of the package, or use insurance. The doctors are private doctors. Hospitals confirm payment or ability to pay up front.
If hospitals or doctors were losing money on this, they’d be complaining and lobbying to get the laws changed. If local or state governments were losing money on it, they’d be complaining and lobbying to get the laws changed. None of them are complaining, none of them are lobbying, none of them are offering statistics.
There is no evidence of deadbeatism. So, the problem isn’t assuming there isn’t enough to worry about, the problem is assuming that there is.
*Note: Medicaid coverage is available, regardless of alien status, if you are pregnant or require treatment for an emergency medical condition and you meet all other Medicaid eligibility requirements.
The interesting bit is when the patient’s life is in danger, they will cover. There are doctors who abuse this and claim emergency medicaid for non-emergency (thought possibly serious) conditions. In this case, for example, Mt. Sinai Cath lab got ~70% of its referrals from ONE single doctor, who told patients to present themselves to the ER as an emergency. They were/are the nation’s leading cath lab. The original lengthy article in on Bloomberg, but it’s paywalled now.
Anyway, the point is hospitals don’t care much because they can game the system* (note there’s 50 different states with 50 different medicaid criterias so this is generalizing).
One thing about the @Timex post above that got @scottagibson so riled up… isn’t it true that Pennsylvania, where Timex and I are both located I think, has a lot more State programs for poor and infirm than a lot of other states? I think the Commonwealth has done a pretty good job of creating safety nets where the Federal Government fails people that other States haven’t done or can’t do. We also have the second largest legislature in the country that comes together to figure this stuff out in Harrisburg. New Hampshire has the largest. More representation for the people results in more interest in problems like this.
In my city there are numerous private resources for the homeless, but there are also rules to use those. Also I think families are given priority. The city has recently finished building (re-building actually) a community of homes for the use of the homeless. Again, families get first dibs I think and there are rules and requirements for the people who chose to live there.
But there are still homeless on the streets in many parts of town. My office is near a confluence of three freeways and there are homeless all around it.
