How many undocumented immigrants were enrolled in Medicaid or CHIP in 2023 in the United States?

1. Why the federal tally is effectively zero — the legal wall that matters

Federal Medicaid and CHIP rules exclude people who are undocumented from full-benefit enrollment except for narrowly defined emergency services, and the same statutes make federal funding unavailable for routine coverage of people without eligible immigration status. This creates a clear administrative cutoff: undocumented immigrants are not eligible for federally funded Medicaid or CHIP enrollment, so no national federal enrollment count should list them as Medicaid/CHIP enrollees for 2023. Analyses emphasize that only certain classes of lawfully present noncitizens qualify and that the presence of exclusionary rules is the primary reason researchers and official tallies do not report a national number of undocumented Medicaid/CHIP enrollees ^{[2] [3]}.

2. Emergency Medicaid is the narrow exception — but it’s tiny in the budget picture

Hospitals and providers can seek reimbursement through Emergency Medicaid for medically necessary emergency services furnished to individuals who otherwise lack eligible immigration status. Policy summaries note that emergency Medicaid spending accounted for less than 1% of total Medicaid spending in 2023, indicating that federal financial flows tied to care for undocumented people are narrowly concentrated and modest relative to total program outlays. This reimbursement pathway is not the same as enrollment in Medicaid/CHIP; it is a claims-payment mechanism for specific emergency services rather than a route to benefits like comprehensive coverage ^[1].

3. States have filled gaps with state-funded programs — numbers are fragmented

Multiple states operate state-funded health coverage programs that extend benefits to undocumented children and, in a limited number of states, to undocumented adults. Those state initiatives bypass federal eligibility restrictions by using state or local funds. The sources reviewed discuss the existence and policy contours of these programs but do not provide a national aggregate of how many undocumented people were enrolled via state-only programs in 2023. Because these programs vary in scope, eligibility, and reporting, a consolidated national figure for state-funded enrollments among undocumented people is not present in the materials examined ^{[3] [4]}.

4. Where analysts do report immigrant shares — lawfully present noncitizens, not undocumented people

Research summaries that parse Medicaid/CHIP enrollees by immigration status typically report small shares of enrollees who are lawfully present noncitizens — for example, eligible noncitizen immigrants accounted for about 6% of Medicaid and CHIP enrollees in the referenced analysis — but those figures explicitly exclude people without lawful status from the eligible noncitizen category. This distinction is crucial: public data and analyses separate lawfully present noncitizens (who may qualify) from undocumented residents (who are ineligible for federally funded enrollment), which is why statements about immigrant shares in Medicaid must be read carefully for the immigration-status definitions used ^{[1] [2]}.

5. Why investigators and policymakers don’t publish a single national number

The absence of a national figure for undocumented enrollees in Medicaid/CHIP stems from three interlocking facts: federal ineligibility removes undocumented people from program enrollment rolls; emergency Medicaid is an episodic reimbursement track rather than an enrollment category; and state-funded programs operate on heterogeneous reporting practices that are not aggregated into a single national tally in the reviewed sources. As a result, the best-supported conclusion from the material is that there were no federally recognized Medicaid or CHIP enrollees who were undocumented in 2023, while some undocumented people received care via emergency Medicaid claims or through separate state-funded programs whose total nationwide enrollment is not reported in these analyses ^{[2] [1] [3]}.

6. What further data would resolve remaining uncertainty

A definitive national count would require three data elements: a federal dataset identifying any exceptions (beyond emergency Medicaid) that permitted undocumented enrollment; a consolidated national report of state-funded program enrollments that target undocumented people; and publicly available tabulations of Emergency Medicaid claims rolled up to beneficiaries rather than claims. The sources reviewed stop short of providing that integrated dataset; they recommend treating federal enrollment counts as excluding undocumented people and looking to state program reports for local totals — neither of which yields a single 2023 national number in the materials examined ^{[3] [4] [1]}.