The White House border affairs chief Tom Homan stated in an interview with Fox News on December 10th that the United States is spending billions of dollars on healthcare for illegal immigrants.
Homan highlighted that the healthcare costs during detention of illegal immigrants by Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) alone amount to tens of billions of dollars annually. The actual total cost might be even higher and difficult to estimate. When discussing welfare issues, Homan stated, “Medical welfare is one thing, but we haven’t even factored in the costs of emergency rooms and hospitalization, which have not been included in the calculations.”
He pointed out that hospitals do not absorb these costs on their own. “Hospitals are in the business of making money, so they shift these costs onto those of us who have insurance, including premiums and deductibles.”
According to a recent audit by the Centers for Medicare & Medicaid Services (CMS), despite explicit federal laws prohibiting it, over $1 billion in Medicaid funds were used for illegal immigrants between 2024 and 2025.
The majority of these funds—around $1.3 billion—were spent in California. Other states that used Medicaid funds for illegal immigrants include Illinois with $29 million, Oregon with $5.4 million, Washington with $2 million, and Colorado with $1.5 million. The District of Columbia also spent $2 million.
A spokesperson for the Health and Human Services Department (HHS) stated on October 31st via email to Epoch Times, “Federal law prohibits the use of Medicaid funds for illegal immigrants, but several Democrat-led states are still doing so.”
The spokesperson added, “The Trump administration will not tolerate such actions. CMS is actively auditing, recouping every dollar, and holding these states accountable. Preventing the waste, fraud, and abuse of Medicaid funds is not an option but a legal requirement. Every dollar misused on medical expenses for illegal immigrants is taking funds away from vulnerable Americans.”
Currently, certain “qualified aliens,” such as lawful permanent residents, parolees, refugees, certain members of Native American tribes, and victims of human trafficking, can apply for Medicaid. According to Department of Homeland Security (DHS) data, over 2.8 million people entered the U.S. on parole between February 2021 and January 2025.
Other groups classified as “qualified aliens” include asylees and individuals legally residing in the U.S. on work or student visas, who are also eligible to apply for Medicaid.
However, President Trump signed the Big and Beautiful Act in July, significantly limiting the federal healthcare benefits only to U.S. citizens, lawful permanent residents, some Cubans and Haitians, and individuals residing in the U.S. under existing agreements with the Federated States of Micronesia and the Republic of the Marshall Islands.
The relevant provisions of the Act are expected to take effect on October 1, 2026.
According to a study released by the Federation for American Immigration Reform (FAIR) in March 2023, by early 2023, the net cost of illegal immigrants to the U.S.—covering local, state, and federal levels—was at least $150.7 billion. This figure is calculated by subtracting around $32 billion in taxes paid by illegal immigrants from the $182 billion in government expenditures.
The study indicated, “Each illegal immigrant, or U.S.-born child of an illegal immigrant, costs the U.S. an average of $8,776 annually.”
In terms of healthcare spending, FAIR estimates that the federal government spends approximately $23.1 billion on medical costs for illegal immigrants, while states collectively spend around $18.6 billion.
FAIR believes that every citizen concerned about America’s future should question the government: why spend such huge sums on those without legal residency rights as costs rise and resources dwindle? “This issue is particularly important because the taxes paid by illegal immigrants can only offset a tiny fraction of the massive costs they incur by staying in the U.S.”
The Department of Homeland Security (DHS) issued a statement on December 10th, stating that over 2.5 million illegal immigrants have left the U.S. during the Trump administration. Tricia McLaughlin, Assistant Secretary for Public Affairs at DHS, stated, “Illegal immigrants have heard our message: leave now. They know that if they don’t leave, we will find them, arrest them, and they will never be able to return to the U.S.”
The large-scale deportation of illegal immigrants is expected to help ease the burden on the federal government in terms of healthcare spending, as well as bring other benefits such as improvements in the job market. DHS noted that the rapid decline in the number of illegal immigrants has had a positive impact nationwide, including the “revival of local employment markets.”