Overview
- Preliminary CMS audits say six jurisdictions used $1,351,204,127 in federal Medicaid dollars to help pay for healthcare for undocumented immigrants, mostly across 2024 and 2025.
- California accounts for roughly $1.3 billion of the total, with additional amounts identified in Illinois (about $30 million), Oregon (about $5.5 million), and Washington, D.C. (over $2 million), plus Washington state and Colorado.
- CMS says further reviews are underway, some money has already been returned, and the agency intends to claw back any improper payments.
- Watchdog Open The Books reports nearly $200 million in direct federal health grants since FY2021 that explicitly reference undocumented beneficiaries, including at least $75.6 million through HRSA.
- Federal law permits emergency Medicaid for anyone but bars federal funds for broader undocumented coverage, a legal boundary at the center of a partisan funding fight tied to the government shutdown.