How many undocumented immigrants receive Medicaid or CHIP in the United States 2023

1. Why the headline—“How many undocumented immigrants get Medicaid or CHIP?”—is hard to answer cleanly

Federal law bars unauthorized immigrants from enrolling in federally funded Medicaid and CHIP, so the straightforward national answer is “virtually none” for standard federal coverage; exceptions are narrow and administrative, such as Emergency Medicaid for acute care ^{[2] [4]}. Multiple recent analytic summaries reiterate that undocumented immigrants remain excluded from routine Medicaid/CHIP enrollment, which means standard national enrollment data do not include a reliable count of undocumented beneficiaries. The absence of a federal enrollment pathway produces a data gap: state programs and hospital emergency payments substitute in limited ways, and those flows are tracked separately or bundled into different reporting streams, preventing a clean national tally ^{[2] [5] [6]}.

2. The small flows that do exist: emergency care and state-funded programs

Hospitals receive federal reimbursement via Emergency Medicaid for urgent care provided to people regardless of immigration status, and federal spending on Emergency Medicaid was about $2.8 billion in 2023—less than 1% of total Medicaid spending—highlighting that emergency services are a narrow, expensive exception rather than routine coverage ^{[3] [4]}. Separately, a growing number of states have created fully state-funded programs for children, pregnant people, and in a few cases adults, regardless of immigration status; California expanded state-funded Medi-Cal to certain young adults and older adults, and states such as Colorado and Washington have launched or planned subsidy or enrollment options for undocumented residents ^{[1] [3]}. These state programs produce localized counts, but they do not change the federal eligibility rule and their enrollment is uneven and incremental ^{[1] [2]}.

3. What recent studies and data show about noncitizen coverage—different metrics, different takeaways

Analyses of immigrant coverage use different denominators and eligibility categories, producing varied snapshots. A 2023-focused study found only 15.7% of noncitizens covered by Medicaid or CHIP and estimated 8.6 million noncitizens uninsured—about 32% of the total uninsured—while projecting that policy changes could render millions newly eligible for federal or Marketplace assistance ^[1]. KFF and other recent syntheses reaffirm that noncitizen immigrants—especially undocumented people—face the highest uninsured rates, with roughly half of likely undocumented adults uninsured in 2023, but these reports stop short of producing a national headcount of undocumented Medicaid/CHIP recipients because of the legal exclusion and data limitations ^[2].

4. Why national enrollment reports don’t yield a simple number

Standard Medicaid and CHIP enrollment reports, including the 2023 MACStats data book and beneficiary profiles, list total enrollment and spending but do not disaggregate enrollment by immigration status in a way that isolates undocumented people receiving regular benefits ^{[5] [6]}. Where undocumented people appear in federal datasets is mainly through Emergency Medicaid billing or through state-level programs reported in state budgets. That fragmentation means researchers can estimate how many noncitizens are uninsured and how many state-funded enrollees exist, but cannot produce a single authoritative nationwide count of undocumented people on Medicaid/CHIP in 2023 without definitional and administrative harmonization ^{[1] [2]}.

5. Bottom line and implications for policy and reporting

The legal baseline is decisive: undocumented immigrants are not eligible for federal Medicaid or CHIP, so regular Medicaid/CHIP enrollment figures do not include them; instead, emergency payments and a patchwork of state-funded programs account for the limited coverage that does exist ^{[2] [4]}. Estimates point to millions of uninsured noncitizens who would become eligible under policy changes—2.2 million for Medicaid/CHIP and 3.5 million for Marketplace credits in one estimate—illustrating the potential scale of change if federal rules shifted ^[1]. Any accurate national count for 2023 would therefore need to compile Emergency Medicaid spending, state program enrollment rolls, and careful survey-based estimates of undocumented populations—work that current public federal reports do not offer in a consolidated form ^{[3] [5]}.