Last August, as part of the federal government’s crackdown on illegal aliens, the Trump administration ordered the names of hundreds of thousands of Medicaid enrollees to be sent to states to determine whether they are ineligible based on their immigration status.
But seven months later, findings from a five-state study shared with KFF Health News show the study uncovered little evidence of a broader problem.
Only U.S. citizens and some legally present immigrants are eligible for the Children’s Health Insurance Program, which is closely related to Medicaid and covers health care costs for people with low incomes and disabilities. Both programs are administered by the state.
Spokespeople for Pennsylvania and Colorado’s Medicaid agencies said that as of March, the states had not identified anyone who needed to cut off Medicaid. The results were a total of 79,000 names.
At the request of the Trump administration, Texas reviewed the records of more than 28,000 Medicaid enrollees and discontinued coverage for 77 of them, said Jennifer Ruffcorn, a spokeswoman for the Texas Department of Human Services.
Ohio has tested 65,000 Medicaid enrollees, and 260 of them have been disenrolled from the program, said Stephanie O’Grady, a spokeswoman for the Ohio Department of Medicaid.
In Utah, Medicaid coverage was discontinued for 42 of the 8,000 enrollees identified by the Trump administration, said Becky Wickstrom, a spokeswoman for the state Department of Labor.
In announcing the review, Health and Human Services Secretary Robert F. Kennedy Jr. said, “We are increasing our oversight of enrollment to protect taxpayer dollars and ensure that these important programs are provided only to those who are truly eligible under the law.”
Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families, said the review ordered by the federal Centers for Medicare and Medicaid Services is unnecessary because states check immigration status when people register.
“It’s entirely predictable that all of these onerous reviews that the federal government is imposing on states will not yield any rewards,” Cuero said. “Each state has already been reviewed once, and CMS is simply re-verifying the same information it has already verified. Making states go through the same bureaucratic process twice is incredibly wasteful and inefficient.”
CMS spokesperson Chris Klepisch said in a statement to KFF Health News that ongoing testing is confirming the eligibility of “certain enrollees whose status could not be verified through federal data sources.”
“CMS provides periodic reports to states for follow-up review, and each state is responsible for independently verifying eligibility and taking appropriate actions consistent with federal requirements,” he said.
But the findings shared by KFF Health News also suggest that many of the registrants whose eligibility the Trump administration says it could not verify are actually U.S. citizens. O’Grady said Ohio found that of the 65,000 names queried by the federal government, 53,000 were confirmed to be citizens and the state already had information indicating their immigration status for Medicaid for an additional 11,000.
Caseworkers then worked through the remaining 1,000 names, verifying information or contacting them for more information, she said.
CMS did not respond to questions about the findings from the states sampled by KFF Health News, nor did it provide information about the responses it received from all 50 states and the District of Columbia that were directed to conduct verification checks.
The agency also did not respond to questions about whether it forwards the names of people whose Medicaid coverage has been terminated to federal immigration officials.
In June, President Kennedy’s advisers ordered CMS to share information about Medicaid enrollees with the Department of Homeland Security, prompting a lawsuit by some states worried that the administration would use the information in unauthorized deportation campaigns against U.S. residents.
A federal judge ruled in December that Immigration and Customs Enforcement officials can illegally access only information about domestic people in the Medicaid databases of states that bring lawsuits.
CMS continues to send a list of names to states at least every few months, but state officials say the number is down from the first shipment last summer.
People without legal status are not eligible for federally funded health insurance, such as Medicaid, Medicare, or plans through the Affordable Care Act Marketplace. Medicaid reimburses hospitals for providing emergency care to people without legal status if they meet income and other program requirements.
Seven states and the District of Columbia offer health insurance regardless of immigration status and fund the program with their own funds.
In March 2025, CMS initiated a financial review of these programs. “CMS has identified more than $1.8 billion in federal funds that are being recovered through voluntary refunds or deferrals of future federal Medicaid payments,” Krepić said. He declined to say how much has been collected so far or from which states.
Total Medicaid spending will exceed $900 billion in fiscal year 2024.
