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Home » News » Emergency Medicaid for Undocumented Immigrants: A Costly Misconception

Emergency Medicaid for Undocumented Immigrants: A Costly Misconception

By Ethan Granger
Published: October 27, 2025
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A recent study reveals that Emergency Medicaid for undocumented immigrants constituted a mere 0.4% of total Medicaid expenditures in the United States for the year 2022. This research, conducted by a team of experts from Emory University, the University of Colorado Anschutz Medical Campus, and Harvard T.H. Chan School of Public Health, analyzed financial data from the Medicaid Budget and Expenditure System for that fiscal year.

Out of 38 states plus Washington, D.C., the study found that spending on emergency Medicaid for undocumented immigrants averaged about $9.63 per resident in these regions. This new insight was shared in a research letter published in JAMA on Thursday morning.

Proponents of the 2025 Budget Reconciliation law argue that reducing Medicaid funding will primarily impact groups they believe should not qualify for benefits, notably undocumented immigrants. However, the researchers point out that, under federal law, undocumented individuals are prohibited from accessing comprehensive Medicaid, Medicare, or Affordable Care Act Marketplace options.

Emergency Medicaid serves a specific purpose, covering emergency medical services for individuals who meet standard Medicaid eligibility criteria but lack U.S. citizenship or legal immigration status. This form of Medicaid is designed to cover immediate, critical medical needs, including:

– Labor and delivery services
– Short-term medical treatment
– In some states, additional treatments such as dialysis and cancer care

Despite the presence of large undocumented populations in certain states, the costs associated with Emergency Medicaid remain minimal, often below 1% of their overall Medicaid budgets. Interestingly, states with larger populations of undocumented immigrants tend to spend approximately 15 times more per person on emergency Medicaid compared to those with smaller populations.

The study’s authors caution that slashing funding for Emergency Medicaid, as suggested in the pending 2025 Budget Reconciliation legislation, would yield scant savings while posing significant risks to healthcare services in states with substantial undocumented communities. This cut would hit safety-net hospitals and providers that serve immigrant populations particularly hard, potentially leading to devastating effects on the availability of vital healthcare services.

Importantly, the study does have some limitations. For instance, 11 states did not report their Emergency Medicaid expenditures, and the analysis did not take into account other public spending aimed at supporting undocumented immigrants.

In conclusion, while Emergency Medicaid often comes under scrutiny amidst budget discussions, this study underscores its minimal financial impact on state budgets. It also highlights the essential role of such programs in providing necessary health services to vulnerable communities. The conversation around Medicaid reform needs to consider the broader implications for healthcare accessibility and outcomes for these populations.First Aid & Emergency

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