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Five states and D.C. spent $1.35B in federal Medicaid funds on undocumented immigrants, violating federal law, CMS says.
A preliminary audit by the Centers for Medicare & Medicaid Services found that five states and Washington, D.C., spent over $1.35 billion in federal Medicaid funds on undocumented immigrants between 2024 and 2025, with California accounting for more than $1.3 billion.
CMS says this violates federal law, which restricts Medicaid funding to U.S. citizens and certain legal residents, and plans to recover the funds.
The audit highlights ongoing disputes over state use of federal health dollars, particularly through mechanisms like the "provider tax" provision, which some argue allow states to funnel federal matching funds into programs for non-citizens.
While federal law mandates emergency treatment regardless of immigration status, critics say states are exploiting loopholes, prompting claims of fraud and misuse.
The findings come amid heightened political debate over immigration, federal spending, and healthcare access.
Cinco estados y D.C. gastaron $ 1.35B en fondos federales de Medicaid en inmigrantes indocumentados, violando la ley federal, dice CMS.