How much do undocumented immigrants contribute to U.S. healthcare costs through taxes and premium payments in 2025?

1. The headline numbers: taxes paid by undocumented immigrants

Recent research used by many outlets estimates undocumented immigrants paid roughly $96–97 billion in federal, state and local taxes in 2022 (widely cited ITEP figure), with about $59.4 billion to the federal government and $37.3 billion to state and local governments; other compilations report similar totals in the high‑$80s to high‑$90s billion range depending on year and method ^{[1] [2] [6]}. These tax payments include payroll taxes (Social Security/Medicare) and income and sales taxes — even though undocumented immigrants are largely ineligible for the federal benefits those payroll taxes fund ^{[1] [7]}.

2. What “contribution to healthcare costs” usually means — and why it’s hard to add up

When people ask how much undocumented immigrants “contribute to U.S. healthcare costs,” they may mean (a) tax and payroll contributions that finance federal programs, (b) premiums paid if they buy private insurance, or (c) direct use of government-funded care (such as Emergency Medicaid). The sources make clear these are separate streams and not all are well‑measured for undocumented populations; federal surveys undercount undocumented people and emergency Medicaid spending can be undercounted too, so a single neat 2025 aggregate isn’t available in current reporting ^{[8] [1] [3]}.

3. Federal eligibility: why undocumented immigrants are rarely counted as program beneficiaries

Multiple health‑policy briefs and fact checks state that undocumented immigrants are not eligible for traditional Medicaid, Marketplace premium tax credits, or Medicare; their access to federally funded coverage is extremely limited and largely confined to emergency care and very limited state programs where states elect to provide coverage ^{[5] [4] [9]}. Therefore, most “contributions” are via taxes paid into systems (including payroll taxes) rather than through enrollment and premium payments to federal programs ^{[1] [5]}.

4. Emergency Medicaid and uncompensated care — a relatively small line item

KFF and other analysts report that Emergency Medicaid (used to reimburse hospitals for emergency care to people otherwise ineligible because of immigration status) represents less than 1% of total Medicaid spending in FY2023, and much emergency Medicaid spending is for labor and delivery services rather than long‑term care ^{[3] [4]}. Fact‑checking outlets note emergency-only reimbursements and uncompensated care are often cited politically, but the magnitudes reported by researchers are far smaller than some public claims ^{[10] [3]}.

5. Premium payments and private insurance

Available sources say undocumented immigrants generally cannot receive Marketplace premium tax credits and in many cases cannot even purchase Marketplace plans; some can buy private coverage directly without subsidies and some states run state‑funded programs that enroll undocumented residents ^{[5] [11]}. Because federal premium subsidies exclude undocumented immigrants, “premium payments” toward subsidized federal coverage are not a meaningful component of their contribution; any private premiums they pay are not aggregated into a national 2025 figure in the sources ^{[5] [11]}.

6. State programs change the picture locally

Several states (California, New York, Illinois, Oregon, D.C., Washington, etc.) have enacted state‑funded coverage or expansions for some undocumented residents; California officials estimated additional state costs tied to newly enrolled immigrants of about $2.7 billion beyond budget expectations in a recent year, and analyses show undocumented Californians pay taxes (estimated $8.5 billion in state/local taxes in one study) that offset some state costs ^[12]. State choices therefore create wide geographic variation — nationwide tax estimates cannot be mapped directly to federal healthcare spending ^{[12] [11]}.

7. Competing narratives and political claims

Political actors have made divergent claims: the White House memo and some Republican messaging put multi‑hundred‑billion dollar figures on immigrant health costs over a decade, while independent analyses and fact checks (including CBO summaries and independent researchers) show much smaller, more specific effects and stress that undocumented immigrants have long been ineligible for most federal coverage ^{[13] [14] [15]}. Fact‑checkers and health policy groups consistently point to the ITEP tax totals and to program rules that limit undocumented enrollment in federal programs ^{[1] [5]}.

8. Bottom line and what reporting does not say

Bottom line: reputable estimates show undocumented immigrants pay tens of billions annually in taxes (roughly $90–97B in cited work) and thereby indirectly help fund programs including Medicare and Medicaid, but they remain ineligible for most federal coverage and account for only a small share of Medicaid emergency spending (under 1% of Medicaid spending in FY2023); there is no single, sourced 2025 total in available reporting that sums their taxes plus premium payments toward U.S. health care costs ^{[1] [3] [5]}. Available sources do not mention a consolidated 2025 dollar figure that combines tax contributions and premium spending into one national number; any such computation would require assumptions not present in the cited material ^{[1] [11]}.