Federal law bans the use of Medicaid funds for illegal immigrants.
Billions of dollars are being spent to cover the health care expenses of illegal immigrants, border czar Tom Homan said in a Dec. 10 interview with Fox News.
Between Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) alone, “we spent billions of dollars a year on emergency care for illegal aliens in our custody,” Homan said. “I think we spent close to a billion dollars on our medical services. So that’s not even counted in these calculations of multiple billions of dollars just in healthcare for illegal aliens. I can’t even tell you what the cost is.”
As for benefits, Homan said, “the health benefits is one thing, but we’re not even talking about the costs of emergency room visits and hospital visits. That’s not even in the calculation.”
He said that hospitals don’t absorb that cost.
“They’re there to make money. So they pass that on to us who have insurance and the co-pays,” he said.
According to a recent audit conducted by the Centers for Medicare & Medicaid Services (CMS), more than $1 billion in Medicaid funds were spent on illegal immigrants in 2024 and 2025 despite federal laws prohibiting it.
The majority of this money—$1.3 billion—was spent by California. Other states that spent Medicaid money on illegal immigrants were Illinois at $29 million, Oregon at $5.4 million, Washington at $2 million, and Colorado at $1.5 million. The District of Columbia also spent $2 million.
“Federal law forbids using Medicaid funds for illegal immigrants, yet several Democrat-led states did it anyway,” a spokesperson for the Department of Health and Human Services, the parent agency of CMS, told The Epoch Times in an email on Oct. 31.
“The Trump Administration won’t tolerate it. CMS is auditing aggressively, recovering every dollar, and holding states accountable,” the spokesperson said. “Protecting Medicaid from waste, fraud, and abuse isn’t optional—it’s the law. Every dollar misspent on illegal health care spending is a dollar taken from vulnerable Americans.”
Currently, certain “qualified aliens,” such as people lawfully admitted for permanent residence, and parolees, can apply for Medicaid benefits. Between February 2021 and January 2025, more than 2.8 million people were paroled into the country, according to the Department of Homeland Security (DHS).
Other groups, such as those with refugee status, members of certain native American tribes, and victims of sex trafficking, can also be categorized under “qualified aliens.”
Asylum seekers and people who are lawfully present in the United States, such as those with work or student visas, are eligible to enroll in Medicaid.
However, the One Big Beautiful Bill Act, signed into law by President Donald Trump in July, narrows down the list of people eligible for federal health benefits, limiting it to only U.S. citizens, lawful permanent residents, certain Cubans and Haitians, and people living in the United States under a prior agreement with the Federated States of Micronesia and the Republic of the Marshall Islands.
This provision of the One Big Beautiful Bill Act is set to come into effect on Oct. 1, 2026.
