What were 2024 healthcare costs attributable to undocumented immigrants across Medicaid, emergency care, and public health programs?

1. What federal Medicaid data actually show: emergency Medicaid is limited and small

Federal analyses and health-policy researchers emphasize that undocumented immigrants are largely ineligible for regular Medicaid and that only Emergency Medicaid — a narrowly defined program to stabilize patients — covers some care for noncitizens; Emergency Medicaid spending was reported as $3.8 billion in FY2023 and about 0.4% of total Medicaid spending, indicating it is a modest share of Medicaid outlays rather than a driver of overall Medicaid costs ^{[1] [2]}.

2. Why national totals are hard to produce: gaps, undercounts, and differing definitions

Multiple sources warn that federal surveys and accounting systems undercount immigrants, particularly undocumented people, and that state-by-state policies vary widely; Emergency Medicaid is tracked differently across states and much uncompensated emergency care is absorbed by hospitals rather than uniformly recorded as immigrant-attributable spending, so available reporting cannot produce a reliable aggregate 2024 national total ^{[4] [1] [5]}.

3. State programs, waivers, and expansions complicate the picture

Some states have created fully state-funded coverage or marketplace subsidy programs for undocumented residents (California, Washington, Colorado, Oregon, New York, and others), which generate state-level spending that is distinct from federal Medicaid spending and varies by program year and enrollment caps; for instance, New York’s 2024 state-funded program for older undocumented residents estimated $230 million for an anticipated cohort, and California reported multibillion-dollar state budget allocations for undocumented coverage in 2024–25 in state budget discussions — but these are state decisions and not uniform federally ^{[6] [7] [8]}.

4. Hospital and state dashboard figures are partial and politically contested

State dashboards and audits sometimes publish figures for uncompensated care or costs attributed to non-lawfully-present patients; Florida’s dashboard and audit-like tallies list county- or hospital-level costs for 2024, and Florida reported estimated total costs in its 2024 admissions-based dashboard, but such dashboards have prompted methodological criticism and political debate about how immigration status is recorded and how costs are allocated ^{[9] [5] [10]}.

5. Political claims and partisan tallies should be treated cautiously

Political offices and advocacy groups provide headline numbers — for example, House committee materials and state press releases have described large cumulative figures or projected costs — but these often mix federal, state, emergency, and other spending categories or extrapolate over multiple years; independent academic and policy sources (KFF, JAMA-associated analyses) caution that emergency Medicaid and immigrant-specific spending are a small share of overall Medicaid and that immigrants in aggregate tend to have lower per-person health expenditures ^{[11] [1] [2]}.

6. What we can say with confidence from available sources

Undocumented immigrants are generally ineligible for most federally funded programs except emergency Medicaid, Emergency Medicaid spending was $3.8 billion in FY2023 and represented roughly 0.4% of Medicaid spending, and state-level programs can add substantial—but variable—state expenditures for undocumented residents, with examples like New York’s $230 million estimate for an older-adult expansion in its first period and California’s legislature-level budget discussions showing multibillion-dollar allocations for 2024–25 coverage initiatives ^{[1] [2] [7] [8]}.

7. Bottom line for your question about “2024 costs across Medicaid, emergency care, and public health programs”

A single, defensible national 2024 dollar figure that bundles Medicaid (beyond emergency Medicaid), emergency care, and public‑health program costs attributable to undocumented immigrants is not provided in the supplied reporting (not found in current reporting). To produce such a total would require harmonized federal and state accounting, careful treatment of emergency vs. full-scope coverage, and reconciliation of state-funded programs and uncompensated hospital care; available federal and peer-reviewed analyses instead point to Emergency Medicaid as a small share of Medicaid spending and to substantial variation across states ^{[1] [2] [6]}.

If you want, I can: (A) compile the specific state-level figures from the sources above into a side-by-side list; (B) identify which agencies or datasets you’d need to query to attempt a national total; or (C) draft questions you could send to specific state Medicaid offices for comparable 2024 data.