For Immigrants to the U.S., a Broken Healthcare System Looms Larger Than Visas

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Key Takeaways

U.S. healthcare costs are projected to reach $7.7 trillion by 2032, affecting immigrants struggling with access, coverage, and expenses.
Provider shortages could hit 86,000 doctors by 2036, worsening access issues for immigrants, compounded by burnout among healthcare workers.
Expiration of Premium Tax Credits in 2025 may leave 3.8 million without insurance, impacting many immigrants reliant on subsidies.

Immigrants planning to move to the United States often focus on visa requirements and potential immigration rule changes. However, an equally pressing issue they must consider is the state of healthcare in the U.S. The country’s healthcare system, often described as broken, offers minimal value despite being one of the most expensive systems globally. This reality hits immigrants particularly hard, as they navigate challenges related to costs, access, and coverage in a system already plagued by inefficiencies.

Key Issues with the U.S. Healthcare System

For Immigrants to the U.S., a Broken Healthcare System Looms Larger Than Visas

Rising Costs but Limited Returns

Healthcare in the U.S. has become increasingly costly over the years. According to the Centers for Medicare & Medicaid Services (CMS), national healthcare spending is on track to grow by an alarming 70% in less than a decade, reaching $7.7 trillion by 2032. For individuals, medical expenses have already hit their highest levels in over a decade by 2025. These expenses weigh heavily on immigrants, who often struggle to secure jobs that offer adequate health insurance.

Despite these rising costs, the value perceived from the healthcare system remains questionable. Many people, including recent immigrants, face immense financial struggles to pay for medical care that may not meet their needs. Coupled with this is the fact that providers often pass inflation-related costs to patients, leading to higher premiums, deductibles, and out-of-pocket expenses—expenses that can drain a household’s finances during an emergency.

Additionally, immigrants commonly experience difficulty finding affordable care due to limited access. A growing number of Americans, about 60%, have at least one chronic disease, with 40% managing two or more. The post-COVID-19 era has only worsened healthcare outcomes, as delayed medical appointments during the pandemic led to an increase in severe health conditions. Immigrants entering this environment must be prepared to make difficult decisions about their health-related expenses.

Medicaid and Medicare: Challenges in Public Coverage

For immigrants who qualify for public health programs like Medicaid or Medicare, the challenges are no less daunting. Medicare, the federal health insurance program mainly for those aged 65 or older, has seen its costs rise dramatically. Spending grew from 2.2% of GDP in 2000 to 3.7% in 2023. Projections estimate that this figure will reach 5% by 2034, further straining resources. With this growth comes the likelihood of reduced coverage or added costs, even for those who meet eligibility criteria.

Medicaid, on the other hand, serves as a safety net program for low-income individuals, including some immigrants. But Medicaid has faced its own set of struggles. The program saw eligibility redeterminations recently, which led to sharp declines in enrollment numbers. Many immigrants who remain in the program belong to high-risk groups with frequent and costly medical needs. As Medicaid continues to grapple with these pressures, its capacity to assist those in need is increasingly at risk.

The payer mix has also shifted significantly in recent years, with Medicaid and Medicare enrollment growing from 43% in 2019 to 45% in 2023. This trend shows a heavier reliance on these public systems, resulting in financial challenges that have left many states struggling to maintain adequate levels of service. For immigrants, these issues are compounded by their reliance on Medicaid during the critical early years of their settlement in the U.S.

Provider Shortages and Staffing Struggles

Even if immigrants can secure insurance, they are likely to face difficulties accessing healthcare providers. Labor shortages in the healthcare industry are worsening by the year. According to estimates from the Association of American Medical Colleges in 2024, the U.S. could see a shortage of up to 86,000 doctors by 2036. This shortfall extends beyond physicians, impacting nurse practitioners, physician assistants, and support staff, making it harder for patients to receive timely care.

Furthermore, healthcare workers—particularly those in critical roles such as doctors and nurses—are leaving their positions at increasing rates due to burnout. A 2024 McKinsey report revealed that about 35% of surveyed doctors plan to leave their jobs within the next five years. Such turnover threatens the quality and continuity of medical care, especially for newly arrived or lower-income individuals who already face barriers to entry into the system.

Private Insurance Woes

Most immigrants must rely on private health insurance purchased through individual markets, given their exclusion from employer-provided insurance plans. However, this route comes with considerable challenges. Marketplace insurance plans, while covering millions, have their own vulnerabilities. If the Marketplace Premium Tax Credits expire as scheduled at the end of 2025, approximately 3.8 million current enrollees could lose their coverage. This includes many immigrants who depend on these subsidies to afford insurance.

The gig economy, which has become a go-to employment option for many immigrants, intensifies these struggles. Because freelance and part-time work offers little to no employer-sponsored benefits, people working in such roles are left with significant coverage gaps. They may find themselves uninsured or underinsured, particularly in cases involving costly treatments for chronic or urgent conditions.

Systemic Challenges Amplifying Concerns

Policy Changes with Far-Reaching Effects

In addition to ongoing systemic issues, recent policy decisions are creating further uncertainties. For instance, Medicare pay rates saw a substantial 2.83% cut on January 1, 2025, creating concerns about patient access for those reliant on the program. Meanwhile, the expiration of specific provisions of the Tax Cuts and Jobs Act is projected to increase health-related taxes by $51 billion between 2025 and 2026. To complicate matters further, temporary measures implemented to broaden telehealth services during the pandemic are also set to expire. Telehealth became an essential tool during the pandemic for immigrants in remote areas, and its rollback threatens access to critical care for underserved populations.

Chronic Disease Burden

For immigrants arriving in a country where chronic conditions are prevalent among residents, dealing with ongoing medical care can quickly become a logistical and financial nightmare. The U.S. has one of the highest rates of chronic conditions globally, and even individuals seeking preventive care are met with substantial out-of-pocket expenses. This context demands that immigrants entering the system prioritize planning for potential healthcare costs.

The Human Impact of Provider Dynamics

Shortages in the number of healthcare providers coupled with high turnover mean that even immigrants who have the means to pay for healthcare may encounter long wait times and rushed appointments. Continuity of care—a situation where a patient is treated consistently by the same medical professionals—is becoming rarer in the U.S., further complicating the effective management of chronic or complex conditions. These issues are forecasted to worsen as the country continues losing essential personnel to burnout and system inefficiencies.

What Immigrants Can Expect

For those planning to immigrate, grappling with the challenges listed above will undoubtedly be part of their transition to life in the U.S. Medical expenses can quickly balloon even for insured individuals due to deductibles, co-pays, and other indirect costs. Managing family medical needs, especially for common chronic conditions, requires knowledge of how the healthcare system operates and access to trusted providers—a combination that many find difficult to secure.

The strain on Medicaid and Medicare funding has ripple effects that make even safety net programs less reliable for qualifying immigrants. And with provider shortages in nearly every specialty, navigating healthcare in the U.S. becomes not just a financial challenge but a time-consuming and emotionally taxing process.

Final Thoughts

While visa hurdles and policy shifts are an important part of an immigrant’s journey to the United States, America’s broken healthcare system may represent the greater challenge. Immigrants face high costs, patchy access, and complex insurance rules, all within a stressed and often inefficient system. As the U.S. moves forward, systemic healthcare reform and efforts to address provider shortages will be critical. For those making this life-altering move, being prepared and informed about the healthcare landscape will be just as important as understanding immigration rules.

For verified and up-to-date information about healthcare in the U.S., the official Medicare and Medicaid Services website offers comprehensive details about coverage plans, costs, and policies.

Influxes of new immigrants will undoubtedly continue shaping the health system conversation moving forward. As analyzed by VisaVerge.com, effective adjustments to how immigrants are assisted within systems, like healthcare, remain critical for ensuring a smoother transition and better outcomes for all stakeholders involved in U.S. society.

Learn Today

Healthcare System → The organized network of healthcare providers, facilities, and services designed to deliver medical care to a population.
Medicaid → A U.S. government program providing health insurance to low-income individuals, including some immigrants, funded jointly by federal and state governments.
Medicare → A federal health insurance program primarily for Americans aged 65 and older or those with certain disabilities.
Out-of-Pocket Expenses → Costs for medical services not covered by insurance, paid directly by the patient, such as deductibles and co-pays.
Telehealth → The use of digital communication technologies to deliver healthcare services remotely, often used in underserved areas or during emergencies.

This Article in a Nutshell

Immigrants moving to the U.S. often prepare for visa requirements but overlook its healthcare system—a costly, access-limited hurdle. With rising expenses, provider shortages, and complex insurance rules, navigating healthcare is daunting. Awareness is crucial: plan ahead, understand coverage options, and prioritize health costs. Preparation ensures smoother transitions into this challenging landscape.
— By VisaVerge.com