Medicaid effort to target undocumented immigrants may create enrollment hurdles
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CMS administrator Mehmet Oz at the White House in July. Photo: Allison Robbert/Bloomberg via Getty Images
Federal health officials announced a new push on Tuesday to ensure that Medicaid and Children's Health Insurance Program (CHIP) enrollees are U.S. citizens or have a satisfactory immigration status.
Why it matters: The effort could create new administrative hoops for enrollees to jump through.
Driving the news: The Centers for Medicare and Medicaid Services will begin providing states with "monthly enrollment reports identifying individuals whose citizenship or immigration status could not be confirmed through federal databases," the Department of Health and Human Services said in a statement.
- The reports will draw on data from sources including the Department of Homeland Security's Systematic Alien Verification for Entitlements (SAVE) program.
- HHS emphasized that states are responsible for reviewing cases, verifying the immigration status of individuals on the CMS' reports, and "taking appropriate actions."
- All states will receive these reports within the next month, per the HHS.
Reality check: Traditional Medicaid coverage is not available to undocumented immigrants.
- "Undocumented immigrants are not eligible to enroll in federally funded coverage including Medicaid, CHIP, or Medicare or to purchase coverage through the ACA Marketplaces," per the non-partisan Kaiser Family Foundation.
- HHS did not respond to Axios' request for comment.
What they're saying: "Every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP," said CMS Administrator Dr. Mehmet Oz.
Between the lines: The change looks to put the burden of proof on the individuals whose immigration statuses the CMS cannot verify through the databases.
By the numbers: Despite the assertions of Oz — and other parts of President Trump's administration — there is not evidence that undocumented immigrants are broadly receiving Medicaid benefits they're not eligible for.
- Medicaid reimburses hospitals for emergency care provided to individuals who meet other eligibility requirements but lack eligible immigration status. Emergency spending rose less than 1% of total Medicaid spending between 2017 and 2023, according to KFF.
- Immigrants in the country legally may also qualify for Medicaid or CHIP, but face eligibility restrictions. There is a five-year waiting period for these modified forms of Medicaid and CHIP, which states can eliminate for children and pregnant people.
An early version of Republicans recently passed tax-and-spending bill would have cut federal payments to states that covered undocumented immigrants with their own funds.
- The provision was dropped after it was found to violate Senate rules.
- The White House claimed that the provision would "protect Medicaid for Americans by removing at least 1.4 million illegal immigrants from the program."
The other side: The 1.4 million figure "is unequivocally false," according to Georgetown University's Center for Families and Children.
- "The 1.4 million immigrants the White House presumably refers to are immigrants who will lose coverage due to reductions in state health care programs, funded by states and not by federal Medicaid dollars."
