Officials say they are working to recover the money.
An audit conducted by the Centers for Medicare & Medicaid Services (CMS) found that more than $1 billion in Medicaid funds have been spent on illegal immigrants, despite a prohibition in federal law.
California alone spent $1.3 billion in Medicaid funds in 2024 and 2025 to cover health care for immigrants illegally in the country, according to the preliminary audit released Friday. Four other states and the District of Columbia also spent funds from Medicaid on illegal immigrants during that time frame.
“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,” 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.
“Federal law forbids using Medicaid funds for illegal immigrants, yet several Democrat-led states did it anyway,” the spokesperson continued. “The Trump Administration won’t tolerate it. CMS is auditing aggressively, recovering every dollar, and holding states accountable.”
According to the audit, from 2024 to 2025, Illinois spent $29 million on health care for illegal immigrants, Oregon spent $5.4 million, the District of Columbia and Washington state spent $2 million, and Colorado spent $1.5 million.
The states and the District of Columbia did not respond to requests for comment.
Medicaid provides health care to about 78 million Americans, a number of whom are low income. Federal law makes the program available for U.S. citizens and certain immigrants, such as refugees, who have legal status.
The only exceptions are for services for emergency medical conditions for illegal immigrants who meet other eligibility requirements and for some immigrant children and pregnant women who are not otherwise able to receive Medicaid, such as people protected under Deferred Action for Childhood Arrivals.
In August, a federal judge blocked CMS from sharing data on Medicaid recipients with the Department of Homeland Security, which handles immigration enforcement.
Health officials later announced they would be looking to make sure that people were not improperly enrolled in Medicaid or the Children’s Health Insurance Program, which provides health insurance at reduced costs to some children and pregnant women.
