Trump administration orders states to review Medicaid eligibility based on immigration status
The Trump administration has mandated states to investigate certain individuals enrolled in Medicaid to determine their eligibility based on immigration status, with five states reporting a collective total of over 170,000 names received. This effort marks an “unprecedented” involvement of the federal government in the state-federal health program amid heightened immigration scrutiny, reports BritPanorama.
Advocates warn that this directive imposes unnecessary verification burdens on states and could result in individuals losing coverage due to missed paperwork deadlines. Only U.S. citizens and select lawfully present immigrants qualify for Medicaid, which caters to low-income and disabled individuals, while those without legal status are categorically excluded from federally funded health programs.
“We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law,” stated Health and Human Services Secretary Robert F. Kennedy Jr. in a press release announcing the verification initiative in August. According to the release, all states are expected to receive names for review within a month.
To gauge the effort’s progress, KFF Health News contacted Medicaid agencies in 10 randomly selected states, with five confirming the approximate number of names received from the Trump administration. Among them, Colorado noted 45,000 names, Ohio 61,000, Pennsylvania 34,000, Texas 28,000, and Utah 8,000, highlighting the challenge faced by a program that serves more than 70 million enrollees.
Most states interviewed opted not to offer further comments. Notably, California, Florida, Georgia, New York, and South Carolina declined to disclose the number of names requested for review.
Beginning in August, the Centers for Medicare & Medicaid Services started sending states names of Medicaid beneficiaries suspected of ineligibility, instructing state agencies to verify their immigration status. Recently, Deputy Health and Human Services Secretary Jim O’Neill shared images on the social platform X of individuals deemed unauthorized residents receiving Medicaid benefits, although he could not be reached for further comment.
Criticism of the initiative has surfaced, with Ben D’Avanzo, a senior health advocacy strategist at the National Immigration Law Center, deeming it a misallocation of state resources that duplicates existing state processes. This crackdown is part of a broader directive from President Donald Trump for federal agencies to curb benefits accessed by unauthorized individuals.
In June, federal advisers directed CMS to communicate Medicaid enrollee data to the Department of Homeland Security, prompting concerns about the potential use of this information for deportation efforts. A subsequent federal ruling in August halted the sharing of this information with immigration authorities.
State Medicaid agencies are tasked with using existing databases from the Social Security Administration and Homeland Security to verify enrollees’ immigration status. This approach raises concerns about inadvertently disenfranchising eligible individuals, particularly if state officials must revert to beneficiaries for additional information, which could lead to unintentional loss of coverage.
“I am not sure that evidence suggests there really is a need for this extra verification,” remarked Marian Jarlenski, a health policy professor at the University of Pittsburgh.
In its August announcement, CMS clarified its expectation for states to verify eligibility for individuals whose immigration status could not be confirmed through federal databases, underscoring the administrative demands that will accompany this endeavor. Leonardo Cuello, a research professor at Georgetown University, labelled the CMS directive as “unprecedented” in the history of the Medicaid program and emphasized the possible implications of outdated information affecting a significant number of beneficiaries.
“It seems clear that this process is intended more for political optics than practical outcomes,” Cuello reflected, casting doubt on the actual effectiveness of the initiative.
State officials, including representatives from Pennsylvania, indicated that while the state already undertakes eligibility verifications, the new directive creates an additional process that requires careful examination of the lists provided by federal agencies.
As Medicaid agencies across states prepare for this challenge, there remains uncertainty regarding the practical implications of the new verification protocols amid ongoing policy shifts. The situation continues to evolve, reflecting the complex intersection of healthcare access and immigration policy.
