- In 2014, 1 in 5 births (791,000) in the US was to an immigrant mother (legal or illegal). Our best estimate is that legal immigrants accounted for 12.4% (494,000) of all births and illegal immigrants accounted for 7.5% (297,000).
- The 297,000 births per year to illegal immigrants is larger than the total number of births in any state other than California and Texas. It's also larger than the total number of births in 16 states and DC, combined.
- The estimated 28,000 births to illegal immigrants in just the Los Angeles metro area's larger than the total number of births in 14 states and DC.
- Among the native-born, a large share of new mothers (42%) are either uninsured or on Medicaid. The rate's even higher among new moms who are legal immigrants (47%) and higher still for new moms who are in the US illegally (67%).
- Illegal immigrants account for 11% (198,000) of all publicly funded births and legal immigrants are another 13% (231,000).
- We estimate that the cost to taxpayers for births to immigrants (legal and illegal) is roughly $5.3 billion — $2.4 billion of which is for illegal immigrants.
- Although immigration adds enormously to the number of births, it raises the nation’s overall birth rate by only 4%, partly because immigrant fertility isn't that much higher than that of natives.
However, the ACS and NCHS don't agree as closely when it comes to the number of births to immigrants specifically. Looking only at US residents, the 2014 NCHS data shows 872,256 births to immigrants, while the ACS shows 790,582 births. The 81,674 difference is partly due to differing definitions. The ACS doesn't count those born aboard to American parents as immigrants. By contrast, the NCHS data records information about the mom’s country of birth only, not her citizenship. Therefore, the NCHS foreign-born number includes those born aboard to American parents. It's possible to calculate the number of births in the ACS data using the NCHS definition of the foreign-born. But the ACS still shows about 5% fewer immigrant births. This may mean that the undercount of immigrant births in the ACS is about 5% because immigrant mothers misreport that they're native-born. For the purposes of this analysis, we accept the figures in the ACS and report them without adjusting for undercount.
Estimating the Illegal Population. Illegal immigrants are present in Census data, but they're never explicitly identified by the Bureau. To determine which respondents are most likely to be illegal aliens, CIS follows a methodology similar to those used by the Pew Research Center and the Center for Migration Studies. We start by eliminating immigrant respondents who are almost certainly not illegal aliens — for example, spouses of natural-born citizens; veterans; people who receive direct welfare payments (except Medicaid for women who gave birth within the past year and for residents of certain states); people who have government jobs; Cubans (because of special rules for that country); immigrants who arrived before 1980 (because the 1986 amnesty should've already covered them); people in certain occupations requiring licensing, screening or a government background check (e.g., doctors, pharmacists and law enforcement); and people likely to be on student visas.
The remaining candidates are weighted to replicate known characteristics of the illegal population (size, age, gender, region or country of origin, state of residence and length of residence in the US) as determined by the Department of Homeland Security (DHS). The resulting illegal population, that consists of a weighted set of ACS respondents, can then be used to infer characteristics not published by DHS, such as births and Medicaid use by illegal aliens.
Of course, all profiles of the illegal immigrant population carry significant uncertainty and the share of births to illegal immigrant mothers across the US are no exception. Since our estimates become less precise in smaller geographic areas, we limit the data for specific metro areas to the 50 largest by total population.
Births Paid for by Taxpayers. The public cost of delivery or post-partum care's paid for by Medicaid under the "pregnancy care" provision administered by the states. Medicaid will pay for a delivery in almost all cases if the mom's uninsured or has a low income, though some mothers without insurance may not even realize the program has paid health care providers. Illegal immigrants and most new legal immigrants are ineligible for Medicaid, but the program will still cover the cost of delivery and post-partum care for these mothers for at least a few months. Funding for Medicaid comes from both the federal government and the states.
In the ACS, 99% of the kids under age 1 whose moms are on Medicaid are also insured by the program. Of new immigrant moms who report they're uninsured at the time of the survey, 84% of their newborns are covered by Medicaid.
By examining new mothers in the ACS who are uninsured or on Medicaid, we're looking at women whose delivery was, in almost all cases, paid for by taxpayers. In fact, the share of all new moms (immigrant and native) who are on Medicaid or uninsured (44%) in the ACS is close to the 43% of all births paid for by Medicaid reported by the NCHS
Estimating the costs of publicly financed births is difficult. The amount that Medicaid spends per birth on mom and kid isn't something the federal government and states report. Adjusting to 2014 dollars, the middle year of the ACS data in this report, would increase the amount to $13,596. We assign this cost to new moms on Medicaid. As discussed above, 84% of uninsured new moms have a kid less than 1 year old who's covered by Medicaid. We therefore assume that 84% of births to uninsured moms were covered by Medicaid. We implement this by assigning only 84% of the cost of publicly funded births to new moms who report they're uninsured at the time of the survey. This is a conservative estimate as it's likely that a larger share of these births were in fact publicly funded since only a small share of births are actually "self-pay". Using this approach produces an estimate of $5.3 billion in taxpayer money going to fund births to immigrants in 2014, $2.35 billion of that's for illegal immigrant births.