Trump’s HHS orders state Medicaid programs — including Colorado’s — to help find undocumented immigrants

By Phil Galewitz KFF Strength News The Trump administration has ordered states to investigate certain individuals enrolled in Medicaid to determine whether they are ineligible because of their immigration status with Colorado and four other states reporting they ve together received more than names an unprecedented step by the federal executive that ensnares the state-federal fitness venture in the president s immigration crackdown Advocates say the push burdens states with duplicative verification checks and could lead people to lose coverage just for missing paperwork deadlines But the administrator of the Centers for Medicare Medicaid Services Mehmet Oz explained in a post on the social platform X on Oct that more than billion of federal taxpayer dollars were being spent on funding Medicaid for illegal immigrants in five states and Washington D C Medicaid s overall spending topped billion in fiscal year It wasn t clear from Oz s comment or an accompanying video over what period the spending happened and CMS spokespeople did not this instant respond to questions either for an earlier version of this article or after Oz s message was posted Only U S citizens and various lawfully present immigrants are eligible for Medicaid which covers low-income and disabled people and the closely related Children s Vitality Insurance Scheme Those without legal status are ineligible for federally funded fitness coverage including Medicaid Medicare and plans through the Affordable Care Act marketplaces Colorado and other states disputed Oz s comments Our payments for coverage of undocumented individuals are in accordance with state and federal laws explained Marc Williams a spokesperson for Colorado s Department of Healthcare Care Approach and Financing which administers the state s Medicaid venture The million number referenced by federal leaders in the current era is based on an incorrect preliminary finding and has been refuted with supporting input by our Department experts He added It is disappointing that the administration is announcing this number as final when it is clearly overstated and the conversations are very much in the mentoring and discussion phase Illinois Medicaid authorities blasted Oz s comments Once again the Trump administration is spreading misinformation about standard uses of Medicaid dollars commented Illinois Medicaid spokesperson Melissa Kula This is not a reality show and there is no conspiracy to circumvent federal law and provide ineligible individuals with Medicaid coverage Dr Oz should stop pushing conspiracy theories and focus on improving medical care for the American people The Washington State Vitality Care Authority which runs the state s Medicaid effort was also blunt The numbers Dr Oz posted on social media this day are inaccurate noted spokesperson Rachelle Alongi We were very surprised to see Dr Oz s post especially considering we continue to work with CMS in good faith to answer their questions and clear up any confusion Charges of misspent Medicaid money In August CMS began sending states the names of people enrolled in Medicaid that the agency suspected might not be eligible demanding state Medicaid agencies check their immigration status KFF Vitality News in October reached out to Medicaid agencies in states Five provided the approximate number of names they had received from the Trump administration with expectations of more to come Colorado had been given about names Ohio Pennsylvania Texas and Utah More than million people are enrolled in Medicaid Majority of those states declined to comment further Medicaid agencies in California Florida Georgia New York and South Carolina refused to say how a multitude of names they were ordered to review or did not respond Oz announced in his X post that California had misspent billion on care for people not eligible for Medicaid while Illinois spent million Oregon million Washington state million Washington D C million and Colorado million We notified the states and plenty of have begun refunding the money he disclosed But what if we had never requested Washington D C s Medicaid director Melisa Byrd reported CMS had identified administrative expenses for the district campaign that covers people regardless of immigration status that should not have been billed to the federal authorities and her agency has already fixed chosen of those areas We run a big initiative that is very complex and when mistakes or errors happen we fix them she noted The scheme plans to pay back to CMS by mid-November All five states plus Washington D C are led by Democrats and President Donald Trump didn t win any of them in the vote In latest days Deputy Physical condition and Human Services Secretary Jim O Neill began posting pictures on X of people he mentioned are convicted criminals living in the U S without authorization who had received Medicaid benefits O Neill could not be reached for comment We are very concerned because this seems frankly to be a waste of state guidance and furthers the administration s anti-immigrant agenda commented Ben D Avanzo senior healthcare advocacy strategist with the National Immigration Law Center an advocacy group This duplicates what states already do he reported Court blocks information sharing As part of the administration s crackdown on people in the U S without authorization President Donald Trump in February directed federal agencies to take action to ensure they are not obtaining benefits in violation of federal law In June advisers to Wellbeing and Human Services Secretary Robert F Kennedy Jr ordered CMS to share information about Medicaid enrollees with the Department of Homeland Safeguard drawing a lawsuit by Colorado and other states alarmed that the administration would use the information for its deportation campaign against unauthorized residents In August a federal judge ordered HHS to stop sharing the information with immigration bureaucrats State Medicaid agencies use databases maintained by the Social Guard Administration and Department of Homeland Safeguard to verify enrollees immigration status If states need to go back to individuals to reverify their citizenship or immigration status it could lead particular to fall off the rolls unnecessarily for example if they don t see a letter requesting paperwork or fail to meet a deadline to respond I am not sure that evidence suggests there really is a need for this extra verification revealed Marian Jarlenski a wellness guidelines professor at the University of Pittsburgh School of Population Strength Oz made clear that the Trump administration disagrees Whether willful or not the states conduct highlights a terrifying reality American taxpayers have been footing the bill for illegal immigrants Medicaid coverage despite a large number of Democrats and the media insisting otherwise Oz announced in his X post In an August press release CMS disclosed it would ask states to verify eligibility for enrollees whose immigration status could not be verified via federal databases We expect states to take quick action and will monitor progress on a monthly basis the agency disclosed Pointless immigration status reviews Leonardo Cuello a research professor at Georgetown University s Center for Children and Families called the CMS order to states unprecedented in the Medicaid plan s -year history He announced the federal authorities may have been unable to verify certain individuals immigration status because names were misspelled or outdated such as when a beneficiary is identified by their maiden instead of married name The names may also include people helped by Exigency Medicaid a scheme that covers the cost of hospital crisis services including labor and delivery for people regardless of immigration status CMS is conducting pointless immigration status reviews for people whose hospital bills were paid by Emergency Medicaid Cuello commented Oz noted in his post that federal law does permit states to use Medicaid dollars for crisis restoration regardless of patients citizenship or immigration status and that states can legally build Medicaid programs for illegal immigrants using their own state tax dollars so long as no federal tax dollars are used The states Oz mentioned all run their own such programs The verification checks create an added burden for state Medicaid agencies that are already busy preparing to implement the tax and agenda law Trump signed in July The measure which Republicans call the One Big Beautiful Bill Act makes multiple changes to Medicaid including adding a work requirement in the greater part states starting by The law also requires the bulk states to more frequently check the eligibility of several adult Medicaid enrollees at least twice a year I fear states may do unnecessary checks that create a burden for chosen enrollees who will lose medical coverage who should not Cuello commented It s going to be a whole lot of work for CMS and states for very little pay dirt Cuello mentioned the effort may have greater political value than actual value Related Articles Gov Jared Polis budget proposal takes aim at Medicaid spending eyes Pinnacol spin-off again Older Coloradans and rural residents face bigger physical condition insurance price hikes Project Angel Heart delivers individually crafted meals to people who are severely ill RTD ridership still falling as state pushes transit-oriented advancement We re not moving the needle Regime shutdown leaves Colorado s locality soundness centers in financial limbo Brandon Cwalina a spokesperson for the Pennsylvania Department of Human Services which runs Medicaid in the state stated the state already requires every Medicaid applicant to verify their citizenship or where applicable their eligible immigration status However he explained the directive issued by CMS constitutes a new process and DHS is scrupulously reviewing the list in order to take appropriate actions Oz did not name Pennsylvania which Trump won in in his post If a lawful resident does not have a Social Guard number the state confirms their legal status by checking a database from Homeland Guard as well as verifying specific immigration documents he noted Other state Medicaid agencies disclosed they also needed to regroup before reaching out to enrollees Our teams just received this notice and are working through a process by which we will perform these reviews Jennifer Strohecker then Utah s Medicaid director informed a state advisory board in August KFF Healthcare News Renuka Rayasam and Rae Ellen Bichell contributed reporting KFF Vitality News is a national newsroom that produces in-depth journalism about wellbeing issues and is one of the core operating programs at KFF an independent source of healthcare guidelines research polling and journalism Learn more about KFF Sign up for The Denver Post s weekly newsletter to get robustness news sent straight to your inbox