How much did the us pay for emergency medical care for undocumented immigrants in 2022?

1. What the best peer-reviewed and journalistic sources say about 2022 emergency Medicaid spending

A multi‑institution research letter analyzing states’ fiscal‑year‑2022 Medicaid Budget and Expenditure System data found emergency Medicaid spending for undocumented immigrants amounted to about 0.4% of total Medicaid spending in 2022, and when limited to 38 states plus D.C. that reported, the authors estimated emergency Medicaid spending equaled roughly $9.63 per resident in those jurisdictions (reported in coverage of the JAMA study) ^{[1] [2]}. MedPage Today and ABC News summarizing the JAMA research emphasize that emergency Medicaid primarily pays for immediate, short‑term care (labor and delivery, some dialysis, cancer treatments in some states) and that the study had limitations including non‑reporting by 11 states ^{[2] [1]}.

2. Why those figures are limited and what they do — and do not — capture

The JAMA study and reporters note clear limitations: 11 states did not report emergency Medicaid expenditures for 2022, and the study does not capture the broader set of social or health‑related spending that might benefit undocumented immigrants (for example, state‑funded programs, uncompensated hospital care, or local health department services) ^{[2] [1]}. Researchers also warn that Emergency Medicaid is a narrow federal eligibility carve‑out — it reimburses emergency‑level services for people otherwise ineligible due to immigration status — so the study’s dollar totals are not a full accounting of all health care costs involving undocumented immigrants ^{[2] [1]}.

3. Contrasting claims from advocacy and political sources

Some political and advocacy organizations have presented much larger numbers for “emergency services” or related costs. For instance, a House committee summary cited in a non‑peer outlet claims $5.4 billion in “emergency services for undocumented” in FY2022; other advocacy pieces and state budget claims (not federal) report multi‑billion figures for state programs such as California’s Medi‑Cal expansion for undocumented residents ^{[3] [4]}. Those larger sums typically combine federal and state spending, different programs (not strictly Emergency Medicaid), or are produced by partisan analyses; the peer‑reviewed/state‑reporting study described above does not corroborate a single national federal emergency‑care total at the multi‑billion level ^{[1] [3] [4]}.

4. Broader context: immigrants’ overall use of health care and who pays

Analyses from health policy researchers emphasize that immigrants — including undocumented populations — generally use less health care and incur lower per‑person health expenditures than U.S.‑born residents, and that Emergency Medicaid accounts for a very small share of overall Medicaid expenditures (one study highlighted Emergency Medicaid as approximately 0.3% of Medicaid spending in prior research; the 2022 study finds 0.4% for undocumented emergency Medicaid) ^{[5] [1] [6]}. Other work notes undocumented immigrants contribute taxes and premiums that offset costs in aggregate, though precise net positions vary by study and methodology ^{[5] [6]}.

5. What reporters and researchers identify as the core policy and political disputes

Researchers focus on data gaps (non‑reporting states, narrow program definitions) and methodological issues; political actors emphasize budgetary impacts and public‑policy choices, sometimes aggregating disparate spending streams into headline totals to make a political point ^{[2] [3] [4]}. Reporting on California, for example, shows state policymakers dispute whether state General Fund spending for expanded coverage (reported in hearings as about $8.5 billion annually) is sustainable — but that is a state cost for expanded full‑scope coverage, not the same as federal Emergency Medicaid national totals for 2022 ^[4].

6. Bottom line for your original question

If you mean “federal Emergency Medicaid payments for undocumented immigrants in 2022,” the best available peer‑review and press summaries indicate a very small share of Medicaid spending — about 0.4% — and per‑resident spending of roughly $9.63 in the 38 reporting states plus D.C.; a precise single nationwide federal dollar total for 2022 is not provided in the reviewed study because of missing state reports and because many other analyses aggregate different program costs ^{[1] [2]}. Claims of multibillion federal emergency‑care costs for undocumented immigrants appear in partisan releases but are not corroborated by the cited academic/state fiscal reporting in the sources above ^{[3] [1]}.

Limitations: available sources do not provide a single, full national dollar figure that includes non‑reporting states or state‑funded programs; where partisan and advocacy sources give very different numbers, they often use broader definitions or different accounting that the peer‑reviewed study did not adopt ^{[2] [3]}.