Immigration Reform's Big Impact on Health Care


Congress has a hot topic on its hands this summer. A proposed immigration reform bill is making its way through the halls of Capitol Hill. While lawmakers argue the pros and cons of the legislation on immigration, the bill also would make a major impact on health care in the U.S.

More spending
According to the Congressional Budget Office, around 8 million unauthorized residents would gain legal status and 10.4 million additional residents would be added to the U.S. by 2023. The CBO says that federal spending will increase by $262 billion over the next decade due largely to refundable tax credits and higher health care spending.

That higher health care spending goes primarily to two areas: Obamacare and Medicaid (including the Children's Health Insurance Program, or CHIP). Additional spending on Obamacare health insurance exchange subsidies will amount to $82.3 billion through 2023, according to the CBO, with another $5 billion hit from lower revenue. Medicaid and CHIP will require $29.3 billion added spending during the same period with the proposed immigration reform.

Medicare spending would only increase by $0.8 billion, but this highlights a larger issue. The CBO only scores the budgetary impact for the first 10 years. Most unauthorized immigrants wouldn't qualify for Medicare until many years from now -- well beyond the CBO's cost calculation time frame.

The CBO did take a stab at going out further in time, with projected increased health care spending of around $470 billion in the 10-year period ending in 2033. However, according to the Center for Immigration Studies, the average age of unauthorized immigrants was around 42 in 2010. Newly incoming immigrants tend to be much younger, with an average age of less than 30. This means that even estimating through 2033 doesn't give a good picture of the ultimate health care costs for the proposed bill.

We should note that the CBO expects increased revenue will exceed the higher costs incurred. Through 2023, around $459 billion of higher revenue is expected resulting from additional taxes paid by legalized residents and new immigrants. These higher taxes assume higher employment levels, according to the CBO, "because the larger population would boost demand for goods and services and, in turn, the demand for labor."

More doctors
One clearly positive impact from the proposed immigration bill would be in enabling more physicians to remain in the U.S. In particular, non-resident physicians who work in areas that have a shortage of health care professionals or at Veterans Administration hospitals will have an easier path to staying in the U.S. with the current immigration reform legislation.

I call this clearly positive because the U.S. faces a physician shortage. The New York Timesreported last year that the nation will have nearly 63,000 fewer doctors than needed by 2015, with that number doubling by 2024. A recent research study led by Dr. Candace Chen of George Washington University confirmed that critical physician shortages loom ahead, especially in rural areas.

Current doctors echo these concerns. A 2013 Deloitte survey found that nearly three-quarters of physicians think that fewer individuals will consider a career in medicine. 62% of respondents said that more physicians will retire early because of changes in the practice of medicine.

More investment ideas?
As always, The Motley Fool looks for an investing angle with any story. How can investors take action based on immigration reform's potential impact on health care?

The best approach would be one that should be successful regardless of whether the bill ultimately becomes law. Focusing on investment alternatives that address the physician shortage issue raised in the immigration reform debate seems to meet that criteria. Even if more physicians from other countries are allowed to stay in the U.S., it won't be enough to fully solve the problem.

With this in mind, telemedicine offers potential to help by enabling physicians to provide care for patients in other geographical areas. Companies that facilitate effective use of telemedicine should do well over the long run.

Cisco looks like one good pick. Technology research firm Technavio touts Cisco as one of the key leaders in telemedicine video conferencing. The firm expects the telemedicine video telecommunications market to grow 18% annually over the next few years. Cisco's Telepresence video conferencing product should rack up big gains if those projections prove true.

Qualcomm is another major player in telemedicine. The company's Qualcomm Life division markets the 2Net platform that supports end-to-end wireless connectivity between medical devices and clinical professionals. Qualcomm Life counts more than 170 organizations in its 2Net ecosystem, including major medical device makers and electronic medical record systems vendors.

Neither stock appears too expensive right now. Cisco has a forward price-to-earnings ratio of less than 12, while Qualcomm's forward multiple stands a little below 13. However, Qualcomm seems to have the better overall growth opportunities, so it could be the better value between the two.

Both stocks also offer decent dividend yields. Cisco's dividend yield stands at 2.8%, while Qualcomm isn't too far behind with a 2.3% yield.

Congress must deal with immigration reform this summer. In the meantime, investors can buy two stocks that help address one of the areas that immigration reform hopes to tackle. Hot topic, hot stocks -- I say go with the stocks.

While passage of immigration reform remains up in the air, Obamacare is here and just cranking up. Still in the dark about how Obamacare might affect you and your portfolio? Don't worry -- you're not alone. To help prepare investors for the massive changes coming to the American health care system, The Motley Fool created a special free report that makes this complex topic easily understandable. Download "Everything You Need to Know About Obamacare" and discover how the law may impact your taxes, health insurance, and investments. Click here for your free copy today.

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Fool contributor Keith Speights has no position in any stocks mentioned. The Motley Fool recommends Cisco Systems. The Motley Fool owns shares of Qualcomm. Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

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