The Trump administration has initiated action to recover more than $1.3 billion in federal Medicaid funds that were improperly spent by Democrat-controlled states on healthcare for illegal immigrants, including individuals convicted of violent crimes such as murder and rape.
Let us be clear about what happened here. This is not a complicated matter of interpretation. Federal law explicitly prohibits the use of Medicaid dollars for healthcare coverage of illegal immigrants, with a narrow exception for emergency treatment only. Yet six blue states apparently decided that federal law was merely a suggestion.
A preliminary audit by the Centers for Medicare and Medicaid Services identified that California, Washington D.C., Illinois, Washington state, Colorado, and Oregon collectively misappropriated $1,351,204,127 in federal Medicaid funds between 2023 and 2025, with the majority of spending occurring in 2024 and 2025.
California leads this parade of fiscal irresponsibility by an astronomical margin, accounting for over $1 billion of the total misused funds. Illinois follows as the second-largest violator with nearly $30 million in improper spending.
The legal framework here is straightforward. States are permitted to provide healthcare coverage to illegal immigrants if they choose to do so, but they must fund such programs exclusively with state tax dollars. Federal Medicaid funds are off-limits except for genuine emergency treatment situations. What these Democrat-led states appear to have done is exploit loopholes in federal law to provide comprehensive healthcare benefits to illegal immigrants using federal taxpayer money.
CMS spokesperson Emily Hilliard made the administration’s position unmistakably clear. “Protecting Medicaid from waste, fraud and abuse is not optional. It is the law. Every dollar misspent on illegal healthcare spending is a dollar taken from vulnerable Americans,” she stated. “Federal law forbids using Medicaid funds for illegal immigrants, yet several Democrat-led states did it anyway. The Trump administration will not tolerate it. CMS is auditing aggressively, recovering every dollar and holding states accountable.”
This revelation comes amid the current government shutdown, with House Majority Whip Tom Emmer directly criticizing Senate Minority Leader Chuck Schumer for leading Democrats in shutting down the government rather than accepting reforms that would close these backdoor loopholes.
The Trump administration released a memo one day into the shutdown arguing that Democrats are resisting GOP reforms specifically designed to prevent blue states from continuing to use federal dollars for illegal immigrant healthcare through alleged loopholes.
The facts present a simple question: Should American taxpayers be forced to subsidize comprehensive healthcare for illegal immigrants, including those with violent criminal histories? The law says no. These states apparently disagreed and spent the money anyway.
Now comes the reckoning. The Trump administration is moving to recover every misused dollar and ensure that federal Medicaid funds serve their intended purpose: providing healthcare to eligible American citizens and legal residents who genuinely need assistance.
Related: College Associations Ask DHS to Waive Trump’s H-1B Application Fee for Academic Institutions
