Many U.S. states are beginning to roll back their extremely generous programs of free healthcare for illegal aliens as federal dollars dry up and state budgets are stretched past the breaking point.
Six states, including Washington, DC, have recently eliminated, reduced, or are planning to scale back state-funded health coverage for immigrants due to budget pressures, according to a report by the left-wing Kaiser Family Foundation.
These changes are in reaction to the 2025 Budget Reconciliation bill passed in Congress last year. The bill, also known as Trump’s “One Big Beautiful Bill Act,” made hefty cuts in federal funding for healthcare for migrants.
States including Illinois, Minnesota, California, Colorado, North Carolina, and Washington state, have cut programs and reduced spending in healthcare coverage for migrants — both legal and illegal — over the past few years, KFF reported this month.
As an example of the reductions, California, for instance, has tightened requirements and eliminating large numbers of migrants who previously qualified for the state’s healthcare programs. Premiums have been introduced — and then raised — and ancillary coverage, including dental care, has been cut. Colorado is cutting back on coverage for pregnant migrants and migrant children. And North Carolina has refashioned its coverage for migrants to adhere strictly to the Trump administration’s latest rules changes.
Federal law also continues to maintain that illegal migrants are ineligible to enroll in federally funded coverage, including Medicaid or CHIP, the ACA Marketplaces, and Medicare.
“As of 2024, there were 24 million noncitizen immigrants, including lawfully present and undocumented immigrants, living in the U.S. Noncitizen immigrants, particularly those who are undocumented, face significant barriers to accessing health coverage and care and are significantly more likely than citizens to be uninsured,” KFF.org added.
This is not to say that all states have begun cutting off migrants from taxpayer-funded healthcare.
Several states, including Massachusetts, Utah and New York, have worked to increase freebies for illegals including healthcare and legal services, KFF noted. And states including Washington, Oklahoma, Hawaii, Rhode Island, and New Mexico have pushed through rules giving migrants greater access to jobs.
Finally, a handful of states have passed state laws making illegal entry a state crime and not just a federal crime. The latest, Mississippi, just passed its law this year. Other states with similar laws include Texas, Louisiana, and Oklahoma.
The costs to the states form migrant healthcare has been monumental. Two states, Florida and Texas, have recently passed rules requiring hospitals to report just how much money they have spent to care for indigent migrants who cannot pay their medical bills. According to reports in Texas early this year, for instance, state hospitals had paid out more than one billion dollars to care for illegal migrants. And as to Florida, in its first year of reporting, the Sunshine State reported that taxpayers picked up $566 million in unpaid medical expenses.
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