Federal and state governments spent billions on health care for illegal immigrants in 2024 and 2025, defying federal law, as border officials and auditors warn of escalating costs borne by U.S. taxpayers.
By yourNEWS Media Newsroom
Billions of taxpayer dollars are being allocated to cover health care expenses for illegal immigrants, despite federal laws explicitly prohibiting such spending, according to Tom Homan, former acting director of Immigration and Customs Enforcement (ICE). In a December 10 interview with Fox News, Homan revealed that ICE and Customs and Border Protection (CBP) spend “billions of dollars a year on emergency care for illegal aliens in our custody.”
“I think we spent close to a billion dollars on our medical services,” Homan stated, clarifying that this figure does not include the broader costs of emergency room and hospital visits for illegal immigrants. “They’re there to make money. So they pass that on to us who have insurance and the co-pays,” he added, emphasizing that hospitals shift these expenses onto insured patients.
A recent audit by the Centers for Medicare & Medicaid Services (CMS) found that over $1 billion in Medicaid funds were improperly spent on illegal immigrants in 2024 and 2025, despite federal prohibitions. California led the spending with $1.3 billion, followed by Illinois ($29 million), Oregon ($5.4 million), Washington ($2 million), Colorado ($1.5 million), and the District of Columbia ($2 million).
“Federal law forbids using Medicaid funds for illegal immigrants, yet several Democrat-led states did it anyway,” a spokesperson for the Department of Health and Human Services (HHS) told The Epoch Times in October. “The Trump Administration won’t tolerate it. CMS is auditing aggressively, recovering every dollar, and holding states accountable,” the spokesperson asserted, adding that “every dollar misspent on illegal health care spending is a dollar taken from vulnerable Americans.”
Under current law, only “qualified aliens”—such as lawful permanent residents, parolees, refugees, and certain Native American tribes—are eligible for Medicaid. Between February 2021 and January 2025, over 2.8 million people were paroled into the U.S., according to the Department of Homeland Security (DHS). Asylum seekers and those lawfully present, such as work or student visa holders, may also qualify for Medicaid in some cases.
However, the One Big Beautiful Bill Act, signed into law by President Donald Trump in July, restricts federal health benefits to U.S. citizens, lawful permanent residents, certain Cubans and Haitians, and individuals from the Federated States of Micronesia and the Republic of the Marshall Islands. This provision is set to take effect on October 1, 2026.
Escalating Financial Burden
A 2023 study by the Federation for American Immigration Reform (FAIR) estimated that illegal immigration cost U.S. taxpayers $150.7 billion annually at the federal, state, and local levels. After accounting for roughly $32 billion in taxes paid by illegal immigrants, the net cost remained staggeringly high.
“Each illegal alien or U.S.-born child of illegal aliens costs the U.S. $8,776 annually,” the study noted. FAIR estimated federal medical expenditures for illegal immigrants at $23.1 billion, with states contributing an additional $18.6 billion. Overall federal spending on illegal immigrants, including education and welfare, reached $66.4 billion, while tax revenue from this demographic totaled just $24.6 billion.
“FAIR believes that every concerned American citizen should be asking our government why, in a time of increasing costs and shrinking resources, it is spending such large amounts of money on individuals who are not authorized to be in the United States,” the report stated.
Policy Shifts and Enforcement
In a December 10 statement, DHS announced that more than 2.5 million illegal immigrants had left the U.S. under the Trump administration’s enforcement policies. “Illegal aliens are hearing our message to leave now,” said DHS Assistant Secretary for Public Affairs Tricia McLaughlin. “They know if they don’t, we will find them, we will arrest them, and they will never return.”
The reduction in illegal immigration is expected to alleviate pressure on health care systems and local economies. DHS reported a “resurgence in local job markets” as a direct result of stricter immigration enforcement.
As debates over immigration policy intensify, the financial strain on taxpayers remains a central concern, with audits and legislative changes aiming to curb unauthorized spending on health care for illegal immigrants.
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