What Does Medicaid Spend on Undocumented Immigrants?

Information like this is hard to come across. It does answer the issues of the impact of undocumented citizens and their impact upon healthcare in the United States. I did search for deeper detail. I am finding Medicaid information to be in withheld.

This article is from MedPage. If you do not have access to MedPage, I did attach an NBC article. Illegal immigrants get healthcare to only stabilize them. In any case, emergency Medicaid care ranges from 4 tenths of 1% to 9 tenths of 1% of the total budget.

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Despite claims of “wasteful spending,” actual expenditures are less than 1% of total budget.

Here’s How Much Medicaid Spends on Undocumented Immigrants | MedPage Today, Shannon Firth

Key Takeaways

• Emergency Medicaid is a limited, federally mandated form of Medicaid that offers coverage to stabilize individuals with serious medical conditions who would otherwise be eligible if not for their immigration status.
• Emergency Medicaid expenditures accounted for a mean of 0.4% of total Medicaid spending, at a mean cost of $9.63 per resident, a cross-sectional analysis showed.
• States with larger undocumented populations spent more on emergency Medicaid, but spending was still less than 1% of the total Medicaid budget.

Emergency Medicaid expenditures accounted for only a fraction of overall Medicaid spending, a cross-sectional analysis showed.

Among 38 states and Washington, D.C., emergency Medicaid expenditures accounted for a mean of 0.4% of total Medicaid spending, at a mean cost of $9.63 per resident, with some variability across states, reported Patricia Mae Santos, MD, of the Winship Cancer Institute at Emory University in Atlanta, and colleagues.

States with larger undocumented populations spent more on emergency Medicaid, accounting for a mean of 0.9% of state Medicaid expenditures among states with the highest undocumented population share compared with 0.1% among states with the lowest undocumented population share (adjusted β coefficient 0.7, 95% CI 0.3-1.2, P=0.003), they noted in a research letter in JAMA.

“The main takeaway is that emergency Medicaid is quite a microscopic percentage of the Medicaid budget. It’s not really a driver of Medicaid costs and Medicaid spending,” Leo Cuello, an attorney and research professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families in Washington, D.C., told MedPage Today.

In passing the 2025 budget reconciliation law, proponents argued that the $1 trillion cuts to Medicaid would only impact people who aren’t eligible for the program, specifically undocumented immigrants, wrote Santos and team.

But federal law already prevents undocumented immigrants from qualifying for comprehensive Medicaid, Medicare, and Affordable Care Act options. The exception is emergency Medicaid, which is a limited, federally mandated form of Medicaid that offers coverage to stabilize individuals with serious medical conditions who would otherwise be eligible if not for their immigration status, the authors explained.

While proponents of the “One Big Beautiful Bill” repeatedly argued that undocumented immigrants or those without legal status are driving “wasteful spending” in Medicaid, Santos noted that “the actual spending is less than 1% of the total Medicaid budget.”

“So, any cuts to the emergency Medicaid program … are going to have very limited meaningful benefit in terms of reducing Medicaid spending, but will ultimately disproportionately harm safety-net hospitals and public hospitals that rely a lot on this funding,” she told MedPage Today, as they shoulder the largest share of individuals without legal status in the setting of an emergency.

Cuello clarified that the change in the budget bill for emergency Medicaid “does not change provider payment rates”; instead, what changes is the share the federal government contributes to paying providers.

Medicaid is jointly funded by federal and state governments. Cuello uses the analogy of a restaurant bill: “The bill is the same. What’s changing is now your friend requires you to pay more of the bill,” but “your picking up more of the bill doesn’t mean the restaurant doesn’t get paid.”

Santos agreed that “that’s what should happen.” However, she said, when state budgets grow thin, “who’s going to get hurt?”

For this analysis, the authors relied on financial management report data for fiscal year 2022 from the Medicaid Budget and Expenditure System. They also looked to other publicly available datasets to measure covariates by state, including Medicaid expansion status, the share of the population in each state that is undocumented, its census region, and political ideology index.

The study represents the “first and most contemporary analysis” of emergency Medicaid spending on both the national and state levels, Santos said.

One limitation of the study was that 11 states did not report emergency Medicaid expenditures in 2022. The authors did conduct an analysis comparing state-level characteristics of reporting versus non-reporting states and found no significant differences.

Another limitation was that the study did not capture the full scope of social spending for the undocumented immigrant population.

Opportunities for future research include studying the impact of Medicaid cuts in the budget bill on immigrant health and access to care in the coming years, Santos noted.

“Emergency Medicaid spending accounts for less than 1% of program’s expenses, study finds,” NBC News