Trump administration investigates Medicaid spending on immigrants in Democratic states

Source: AP

Updated 9:11 AM EDT, September 5, 2025


SACRAMENTO, Calif. (AP) — The Trump administration is taking its immigration crackdown to the health care safety net, launching Medicaid spending probes in at least six Democratic-led states that provide comprehensive health coverage to poor and disabled immigrants living in the U.S. without permanent legal status.

The Centers for Medicare and Medicaid Services is scouring payments covering health care for immigrants without legal status to ensure there isn’t any waste, fraud or abuse, according to public records obtained by KFF Health News and The Associated Press. While acknowledging that states can bill the federal government for Medicaid emergency and pregnancy care for immigrants without legal status, federal officials have sent letters notifying state health agencies in California, Colorado, Illinois, Minnesota, Oregon and Washington that they are reviewing federal and state payments for medical services, such as prescription drugs and specialty care.

The federal agency told the states it is reviewing claims as part of its commitment to maintain Medicaid’s fiscal integrity. California is the biggest target after the state self-reported overcharging the federal government for health care services delivered to immigrants without legal status, determined to be at least $500 million, spurring the threat of a lawsuit.

“If CMS determines that California is using federal money to pay for or subsidize healthcare for individuals without a satisfactory immigration status for which federal funding is prohibited by law,” according to a letter dated March 18, “CMS will diligently pursue all available enforcement strategies, including, consistent with applicable law, reductions in federal financial participation and possible referrals to the Attorney General of the United States for possible lawsuit against California.”

Read more: https://apnews.com/article/medicaid-immigrants-california-trump-administration-e45ed693630cce4321f0c0d0b07de442