Sacramento, US, Sep 5 (AP)—The Trump administration's intensified focus on immigration extends to a crucial area: the health care safety net. Under scrutiny is Medicaid spending in six states led by Democrats, which covers comprehensive health care for poor and disabled immigrants living in the U.S. without permanent legal status.
The Centers for Medicare and Medicaid Services (CMS) is meticulously examining payments for health care services provided to immigrants without legal status to root out any possible instances of waste, fraud, or abuse. Important documents obtained by KFF Health News and The Associated Press indicate that while states can rightfully bill the federal government for emergency and pregnancy care for this group, federal officials have begun notifying health agencies in California, Colorado, Illinois, Minnesota, Oregon, and Washington about ongoing reviews of claims for medical services including prescription medicines and specialized care.
CMS maintains it is acting within its remit to ensure the prudent use of Medicaid funds. This probe comes after California self-reported overbilling the federal government by at least $500 million for services to undocumented immigrants, which has led to potential legal action.
These investigations coincide with budget cuts driven by the White House and a Congress controlled by Republicans, reducing taxpayer funding for immigrant health care. The administration is also working to remove individuals living illegally in the U.S. from Medicaid coverage. Health policy experts warn that these measures may strain safety net hospitals and clinics, with California, Illinois, and Minnesota already cutting or scaling back Medicaid programs due to rising costs. Colorado is also revisiting its budget to avoid overruns.
In opposition, 20 states are legally challenging the administration's decision to share Medicaid data with deportation officers, temporarily halted by a federal judge. Rob Bonta, California's attorney general, criticizes the probes as an attack on states that extend Medicaid to immigrants, seeing charges of waste and abuse as contrived pretexts for an anti-immigrant policy.
Under current regulations, immigrants lacking permanent legal status are not eligible for full Medicaid coverage. However, 14 states plus Washington, D.C., have expanded Medicaid using state funds to cover low-income children without legal status, with some also covering adults. The Trump administration is scrutinizing states offering full benefits to unauthorized adults and children under Medicaid, excluding those like Utah, Massachusetts, and Connecticut, which only cover children.
Catherine Howden, a spokesperson for CMS, defends the agency's mandate to ensure proper use of Medicaid funds by stating that certain states have overstepped legal boundaries in providing extensive benefits to unauthorized individuals. This oversight aims to ensure federal resources prioritize legally eligible recipients.
Economic and health policy analysts contend that preventive Medicaid services for immigrants might reduce future health care costs and help keep insurance premiums steady, as well as lower uncompensated care expenditures for hospitals. Francisco Silva, leader of the California Primary Care Association, argues that the administration's actions could escalate health care costs and worsen service accessibility, potentially crowding emergency rooms and raising public health risks.
California, which has integrated health coverage for 1.6 million undocumented immigrants since 2016, faces a $12.4 billion price tag this year, with $1.3 billion shouldered by the federal government for emergency and maternity care. Former state officials revealed that California mistakenly billed federal authorities for non-emergency services which were not previously reported.
Jacey Cooper, who led California's Medicaid program, identified these faults and reported them to federal regulators, aiming for transparency and recovery of at least $500 million. However, ambiguities remain over the recouped amounts and their breakdown.
With Medicaid serving 15 million people in California under a nearly $200 billion budget, mistakes occasionally occur due to complex overlapping federal and state stipulations. Matt Salo, a Medicaid expert, acknowledges the authority of states to manage and identify any misuse of funds.
Critics like Michael Cannon of the Cato Institute describe the administration's actions as targeting a vulnerable minority and not aligned with protecting Medicaid's financial health.
National Republican initiatives continue targeting immigrant health funding. President Trump's "One Big Beautiful Bill" will reduce federal reimbursement for emergency services to undocumented immigrants, impacting California's budget significantly. The administration also aims to limit Medicaid for immigrants with temporary legal status and plans monthly updates for states pointing out the legal status of Medicaid enrollees.
CMS Administrator Mehmet Oz asserts that every misspent Medicaid dollar is detrimental to eligible individuals in need, emphasizing the agency's commitment to program integrity and proper allocation of taxpayer money. Despite these statements, affected states assert their adherence to legal protocols, highlighting the vital role of Medicaid in providing essential emergency care.
Washington state officials confirm that Medicaid benefits for emergency services are critical for residents, while Illinois faces CMS pressure with potential funding cessations if compliance doesn't improve. These states underline the difficulty of compensating for any withdrawal of federal funds, which are crucial for supporting vulnerable populations.
(Only the headline of this report may have been reworked by Editorji; the rest of the content is auto-generated from a syndicated feed.)
