HHS Expenditures on Refugees, 2005-2014

September 5, 2017

This document provides estimates of expenditures from the major HHS programs
assisting refugees over the 10-year period from 2005 through 2014. In this document, any
individual having entered the United States since 1980 as a refugee, or having received asylum,
or another special immigrant visa, including Cuban/Haitian entrant or victim of trafficking is
considered a refugee. Individuals who later changed their immigration status to legal
permanent resident or citizen are included in this analysis as well. Apart from expenditures
associated with refugees, the document also reports expenditures for refugees and their non-
refugee spouses and minor children.
The total cost of major HHS programs supporting or benefitting refugees from 2005
through 2014 was $96.65 billion. Table 1 shows total costs, broken out for federal and state
governments. Costs accrue to state governments as three programsMedicaid/CHIP, Child Care
Subsidies, and TANFrequire state matches to federal dollars. Overall, states paid about a
quarter of HHS-related costs.

Table 1. Expenditures for Major HHS Programs for Refugees, 2005-2014

Refugees Refugees & Spouses, Children
Millions Percent Millions Percent
Total $96,650 100% $125,696 100%
Federal $74,739 77% $94,832 75%
State $21,911 23% $30,864 25%
Values expressed in 2014 dollars

Table 2 presents annual per capita expenditures for refugees and the total U.S. population. In an
average year over the 10-year period, per capita refugee costs for major HHS programs totaled
$3,300. Per person costs for the U.S. population were lower, at $2,500, reflecting a greater
participation of refugees in HHS programs, especially during their first four years in the U.S.

Table 2. Annual Per Capita Expenditures for Major HHS Programs for Refugees and US
Population, 2005-2014
Refugees and
Refugees spouses, children U.S. Population
Total $3,346 $2,793 $2,501

Federal $2,587 $2,107 $2,186

State $759 $686 $315

Values expressed in 2014 dollars

Table 3 breaks down total expenditures by program.

 Table 3. HHS-Related Expenditures for Refugees by Program, 2005-2014 *
(Costs in millions)

Refugees Refugees, Spouses & Children

Total Federal State Total Federal State

Medicaid/CHIP $47,554 $26,146 $21,408 $65,338 $35,924 $29,414

Medicare $39,251 $39,251 $0 $45,811 $45,811 $0

ORR Transitional Assistance
$3,245 $3,245 $0 $3,245 $3,245 $0
and Medical Services
DSH Payments $2,919 $2,919 $0 $5,348 $5,348 $0

ORR Social Services $1,609 $1,609 $0 $1,609 $1,609 $0

TANF $993 $541 $452 $2,045 $1,114 $931

ORR Targeted Assistance $508 $508 $0 $508 $508 $0

LIHEAP $220 $220 $0 $299 $299 $0

Health Centers $186 $186 $0 $289 $289 $0

Child Care Subsidies $113 $62 $51 $1,154 $634 $519

ORR Preventive Health $52 $52 $0 $52 $52 $0

Total $96,650 $74,739 $21,911 $125,696 $94,832 $30,864

Values expressed in 2014 dollars.

*non-HHS refugee expenditures include Social Security, Social Security Disability Insurance, Supplemental
Security Income, National School Lunch Program, Supplemental Nutrition Assistance Program (SNAP), Woman,
Infants, and Children (WIC) Special Supplemental Nutrition Assistance, K-12 Pulblic Education, Publich funding
for higher education, Criminal justice and corrections costs, Bureau of Population, Refugees, and Migration, US
Citizenship and Immigration Services, Child Care Tax Credit, Earned Income Tax Credit, State Earned Income Tax
Credit, other State and Local government costs.
Table 4 reports annual per capita expenditures by program, for refugees, refugees and their non-refugee spouses and minor children,
and the total U.S. population. With the exception of Medicare and LIHEAP (the Low Income Home Energy Assistance Program),
refugees have greater expenses across programs, reflecting their below average economic circumstances and eligibility for means-
tested programs.

Table 4. Annual Per Capita Expenditures for Major HHS Programs for Refugees and U.S. Population, by Program 2005-2014
Refugees Refugees and Families U.S. Population

Total Federal State Total Federal State Total Federal State

Medicaid/CHIP $1,646 $905 $741 $1,452 $798 $654 $731 $402 $329

Medicare $1,359 $1,359 $0 $1,018 $1,018 $0.0 $1,631 $1,631 $0

ORR Transitional Assistance
$112 $112 $0 $72 $72 $0.0 $1 $1 $0
and Medical Services
DSH Payments $101 $101 $0 $119 $119 $0.0 $73 $73 $0

ORR Social Services $56 $55 $0 $36 $36 $0.0 $1 $1 $0

TANF $34 $18 $16 $45 $25 $21 $30 $16 $14

ORR Targeted Assistance $18 $17 $0 $11 $11 $0.0 $1 $1 $0

LIHEAP $8 $7 $0 $7 $7 $0.0 $8 $8 $0

Health Centers $6 $6 $0 $6 $6 $0.0 $4 $4 $0

Child Care Subsidies $4 $2 $2 $26 $14 $12 $23 $12 $10

ORR Preventive Health $2 $1 $0 $1 $1 $0.0 $0 $0 $0

Total $3,350 $2,600 $750 $2,800 $2,100 $700 $2,500 $2,150 $350
Values expressed in 2014 dollars.