Trump Administration’s Review of Medicaid Enrollees Yields Minimal Findings
In August, the Trump administration initiated a federal crackdown on illegal immigration by ordering states to assess the eligibility of hundreds of thousands of Medicaid recipients based on their immigration status. This sweeping measure aimed to ensure that taxpayer-funded health programs were appropriately allocated.
However, findings from a recent five-state study revealed little evidence to support concerns over widespread ineligibility among these enrollees, according to KFF Health News. The investigation has surfaced minimal issues, contradicting the initial premise of the review.
Eligibility for the Children’s Health Insurance Program (CHIP), closely tied to Medicaid, is restricted to U.S. citizens and lawful immigrants. Both programs are managed at the state level and have specific guidelines regarding income and disability.
According to officials from the Medicaid agencies in Pennsylvania and Colorado, as of March, no enrollees were identified for disenrollment based on the review, despite a combined total of 79,000 names being analyzed across the states.
In Texas, at the Trump administration’s request, officials evaluated over 28,000 Medicaid recipients and found that only 77 required termination of their coverage, as reported by Jennifer Ruffcorn, a spokeswoman for the Texas Department of Human Services. Meanwhile, Ohio analyzed 65,000 enrollees and disenrolled 260 individuals, according to Stephanie O’Grady, a spokesperson for the Ohio Department of Medicaid.
Utah’s review of 8,000 enrollees resulted in the discontinuation of coverage for just 42 recipients. These outcomes provoke questions about the necessity and efficacy of the extensive review being carried out on state Medicaid programs.
Health and Human Services Secretary Robert F. Kennedy Jr. announced the initiative as a means to enhance oversight of Medicaid enrollment to safeguard taxpayer funds and ensure compliance with legal eligibility requirements. Nonetheless, experts like Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families, argue that these verifications are redundant. Cuello highlighted that states already conduct checks on immigration status during the registration process, deeming the federal review both unnecessary and wasteful.
CMS spokesperson Chris Klepisch noted that ongoing evaluations are crucial for verifying the eligibility of enrollees whose immigration status could not be confirmed through federal databases. He confirmed that each state is tasked with independently validating eligibility and acting according to federal guidelines. Despite this oversight, the findings indicate that many individuals flagged for review by the Trump administration are, in fact, U.S. citizens. In Ohio, for instance, 53,000 of the 65,000 names queried were confirmed citizens.
Despite a lack of clear data on the national impact, the Centers for Medicare & Medicaid Services (CMS) continues to compile and send names to states periodically, although officials report a decline in the number of names compared to last summer’s initial dataset. Additionally, President Kennedy’s administration directed CMS to share Medicaid enrollee information with the Department of Homeland Security, raising concerns and prompting legal action from some states fearing misuse of data for deportation purposes. A federal judge later ruled that such information can be accessed only under specific legal conditions.
Those without legal status are not eligible for Medicaid, Medicare, or ACA Marketplace plans, although Medicaid does cover emergency medical care for certain undocumented individuals who meet income and other requirements. Notably, seven states and the District of Columbia offer health insurance to all residents regardless of immigration status, funded entirely with state resources. In a financial review initiated by CMS in March 2025, over $1.8 billion in federal funds has been identified for potential recovery through voluntary refunds or deferrals, though specific amounts collected remain undisclosed. The total Medicaid expenditure for the fiscal year 2024 is projected to exceed $900 billion.
