The Trump administration warned state governments Tuesday that it plans to crack down on Medicaid dollars subsidizing the health care of illegal immigrants.
The Centers for Medicare and Medicaid Services (CMS) warned state officials in a letter that it is “ramping up financial oversight activities” by closely scrutinizing state Medicaid programs to ensure their beneficiaries are American citizens.
The enforcement measures will include increased scrutiny of quarterly spending reports from which federal spending for state’s Medicaid costs are determined and reviews of select states’ financial management systems. CMS is also reviewing eligibility rules for loopholes through which money flows to non-citizens and encouraging states to review their own internal controls and IT systems.
“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” said CMS Administrator Dr. Mehmet Oz in a statement. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice—CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”
The action follows the May 22 House passage of President Donald Trump’s “one big, beautiful bill,” which curtails federal reimbursements for 14 states that have expanded Medicaid coverage to illegal immigrants, according to the Kaiser Family Foundation. The bill now heads to the Senate.
Some Medicaid changes are a sticking point for Senate Republicans Josh Hawley of Missouri, Lisa Murkowski of Alaska and Susan Collins of Maine.
The crackdown will ensure federal money won’t subsidize health care “for individuals with an unsatisfactory immigration status in a manner contrary to federal law,” the letter states, citing a 1996 law that says that it is national policy that ‘‘[i]t is a compelling government interest to remove the incentive for illegal immigration provided by the availability of public benefits,” and a February 2025 executive order that reiterated the principle that “federal payments to states and localities do not, by design or effect, facilitate the subsidization or promotion of illegal immigration.”
When it comes to people who do not have an eligible immigration status, Medicaid dollars can only underwrite emergency care, the letter states.
President Donald Trump has repeatedly said it’s important that Medicaid dollars reach Americans.
(Featured Image Media Credit: Screenshot/Rumble/Fox News)
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