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Fact check: How much does the US spend on social services for illegal immigrants annually?
Executive Summary
The best empirical measure for "social services" directed specifically at undocumented immigrants in the United States is emergency Medicaid, and multiple recent state-level expenditure analyses place that share at about 0.4% of total Medicaid spending in 2022, rising to roughly 0.9% in states with larger undocumented populations, implying per‑resident emergency‑Medicaid costs of about $9.63 in 2022; these figures show that direct emergency‑health outlays for undocumented immigrants are a very small fraction of overall Medicaid budgets [1] [2] [3]. Policymakers who cite large annual national tabulations of “social‑service” spending on unauthorized immigrants typically rely on broader fiscal models or estimates of net fiscal impact, which produce very different conclusions depending on assumptions about taxes, long‑run benefits, and policy actions such as mass deportation; for example, Penn Wharton modeled multi‑hundred‑billion dollar fiscal consequences from large‑scale deportation policies, underlining that the biggest fiscal effects come from policy choices, not routine emergency care spending [4] [5].
1. Why emergency Medicaid is the clearest quantified line item — and why it’s tiny
The most direct and recent empirical series isolates emergency Medicaid spending on undocumented immigrants because federal law bars routine Medicaid coverage for most noncitizens, while emergency care remains a measurable federal/state outlay; multiple independent analyses of 38 states put that spending at 0.4% of total Medicaid expenditures in 2022, with higher concentrations in states with larger undocumented populations reaching about 0.9% — translating to roughly $9.63 per resident in the jurisdictions analyzed. These studies are explicitly focused on emergency health services, not the much broader and politically loaded category “social services,” and they reach essentially the same numeric conclusion across publications released in October 2025, indicating a narrow, well‑established data point that direct emergency Medicaid costs for undocumented people are under 1% of Medicaid spending [1] [2] [3]. That concentration and consistency across multiple state analyses make emergency Medicaid the most defensible, recent, and comparable estimate available.
2. What these figures do not capture — the large universe of omitted costs and benefits
Even accurate emergency‑Medicaid numbers leave out many budget lines that are sometimes included in public debate: K‑12 education, local public safety, certain state‑level social services, and portions of uncompensated care are funded in mixed ways and are not captured by those Medicaid estimates. Several common claims about “billions” or “tens of billions” in annual spending on undocumented immigrants aggregate disparate items — some local, some state, some federal — or model lifetime fiscal impacts rather than measured annual outlays; the studies cited here do not attempt to quantify every possible local or indirect cost, and many news or advocacy claims therefore mix incompatible metrics. The absence of a single comprehensive federal accounting means any headline figure beyond emergency Medicaid relies on assumptions about which programs to include and how to apportion shared costs between citizens, legal residents, and undocumented people [6] [7] [8] [9] [10].
3. Broader fiscal research shows policy choices drive large swings, not routine service use
Macro fiscal modeling produces dramatically different answers because it includes taxes paid by immigrants, long‑run economic contributions, and costs or savings from proposed enforcement or deportation policies. For example, Penn Wharton’s modeling of mass deportation scenarios shows hundreds of billions in added deficits under large deportation policies, demonstrating that enforcing or rolling back immigration at scale is far more fiscally consequential than the routine emergency care figures reported for 2022; conversely, other models (e.g., Manhattan Institute updates) find that some immigrant cohorts narrow long‑run deficits by contributing taxes, especially those with higher skills. These contrasting outcomes underscore that the fiscal story depends on scope and policy assumptions — whether analysts model current measured outlays (small) or the fiscal effects of large policy changes or lifetime trajectories (potentially large) [4] [5].
4. What journalists and policymakers should be careful to clarify when citing numbers
When officials or commentators state “the US spends X on social services for illegal immigrants annually,” they must specify which programs are included, the time frame, and whether figures reflect measured annual outlays or modeled lifetime costs/benefits; emergency Medicaid is the only large federal program with a relatively clean, recent measured estimate showing under 1% of Medicaid spending, while other categories require allocations, proxies, or modeling choices. Many source documents in the public record either do not provide state‑level breakdowns or explicitly avoid aggregating across differently funded services, creating room for selective presentation that can amplify either fiscal cost or fiscal benefit depending on intent. Clear, comparable claims should cite the narrow emergency‑Medicaid figures for measured federal/state health spending and separately label any modeled or aggregated totals as projections or estimates [1] [2] [3] [6] [11].
5. Bottom line: measured federal/state emergency health spending is small; broader fiscal effects are contested
Measured emergency Medicaid spending for undocumented immigrants in 2022 is consistently estimated at about 0.4% of Medicaid spending (up to ~0.9% in some states), or roughly $9.63 per resident in the studied jurisdictions, making routine federally and state‑funded emergency health outlays for undocumented people a very small share of Medicaid budgets. Broader claims about total annual “social‑service” spending depend on inclusion choices and modeling assumptions; large projected fiscal impacts arise primarily from policy changes (e.g., mass deportation) or long‑term lifecycle accounting, not from the routine emergency medical spending captured in the October 2025 analyses. Readers and policymakers should use the emergency‑Medicaid figure as the best measured baseline and treat larger headline totals as model‑dependent projections requiring careful unpacking [1] [2] [3] [4] [5].