A new study warns that expanded Medicaid access for illegal aliens under the Biden administration is burdening U.S. hospitals and could cost taxpayers billions annually.
The Biden administration has widened access to Medicaid for millions of illegal immigrants, creating significant concerns about the future sustainability of the U.S. healthcare system. A recent study by the Foundation for Government Accountability warns that these changes, along with states’ expanded Medicaid coverage, are placing a severe financial strain on hospitals and costing taxpayers billions of dollars.
The study reports that in just nine states—such as Arizona, Kentucky, Missouri, Texas, Wisconsin, Pennsylvania, and Michigan—the number of illegal immigrants on Medicaid increased by 500% between 2019 and 2023. This surge in enrollment led to a taxpayer cost increase of 550% in five of the states that provided financial data, highlighting the economic toll of the changes.
The Biden administration has also weakened the verification process for determining a patient’s eligibility for Medicaid by extending the grace periods given to applicants. Under current federal guidelines, if a patient’s citizenship cannot be confirmed through sources like Social Security, they are given a 90-day period to provide documentation. However, these grace periods are frequently extended, allowing illegal immigrants to remain covered under Medicaid for extended periods. Health and Human Services prevents states from limiting these extensions as long as patients claim to be making a good faith effort to prove their eligibility.
These loopholes have effectively created a form of “catch and release” within the U.S. healthcare system. Overburdened hospitals struggle to verify patients’ legal status, leading to a growing number of undocumented immigrants receiving benefits under Medicaid. According to Hayden Dublois, analytics director at the Foundation for Government Accountability, “Nationwide, taxpayers could soon be paying tens of billions of dollars on health care for people who have no right to our safety net—including those who have no right to be in the country.”
In addition to federal actions, several states have expanded Medicaid coverage to illegal immigrants. For example, New York now allows illegal immigrants aged 65 and older who meet income requirements to enroll in Medicaid. California and Oregon have taken similar steps, with California’s Medicaid spending on illegal immigrants costing state taxpayers about $4 billion annually.
Some states, however, are pushing back. In Florida, under Governor Ron DeSantis, hospitals that accept Medicaid are now required to ask patients about their immigration status. This policy shift led to a 54% drop in Medicaid spending on emergency care for illegal immigrants as of June.
The Kaiser Family Foundation estimates there are approximately 21.2 million noncitizen immigrants in the U.S., with about 40% of them undocumented. While undocumented immigrants are ineligible for full Medicaid coverage, they are still able to access emergency Medicaid if they meet their state’s eligibility requirements. States like California and New York have gone beyond these provisions, offering more comprehensive Medicaid coverage to illegal immigrants.
The Biden administration’s 2021 decision to halt the issuance of “no match” letters from the Social Security Administration has further complicated the situation. These letters previously informed employers when a worker’s information did not match Social Security records, helping to flag illegal employment. Without these checks in place, illegal immigrants have an easier time gaining access to healthcare benefits.
The long-term financial impact of these policies remains uncertain, but experts are already warning of the strain it places on U.S. hospitals. “Medicaid pays much less than private insurance, so burdening hospitals with illegal aliens will lead to mounting red ink,” Dublois said. “Some hospitals have already closed, especially in states that expanded Medicaid under Obamacare, and covering illegal aliens will likely cause more to follow suit.”
As the situation continues to develop, many are calling for stricter immigration policies and more rigorous verification processes to ensure that Medicaid and other social safety nets are not overwhelmed by the increasing number of illegal immigrants receiving coverage.
