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How many undocumented immigrants are currently receiving state-funded healthcare in the US?
Executive Summary
State-level programs in at least a dozen states and Washington D.C. provide fully state-funded health coverage to some undocumented children and, in a smaller set of states, to some adults, but there is no authoritative national count of undocumented immigrants currently receiving state-funded healthcare. Available analyses and program reports give concrete enrollment snapshots in individual programs (for example, California’s expansion and Colorado’s OmniSalud), federal spending for emergency-only care, and repeated findings that undocumented immigrants are generally ineligible for federally funded Medicaid, so any nationwide total must be assembled from disparate state reports rather than a single federal source [1] [2] [3] [4] [5].
1. Why you can’t find a single national number — the data gap that matters
Federal rules exclude undocumented immigrants from routine Medicaid eligibility, leaving states and local programs to document any publicly funded coverage they provide; as a result, no centralized federal dataset reports the national count of undocumented people in state-funded programs. State programs vary in eligibility, scope, and reporting: some are explicitly “Medicaid-equivalent” and track enrollments, while others are subsidy or pilot programs with limited reporting. Researchers and policy analysts repeatedly note that the landscape must be pieced together state-by-state because Emergency Medicaid is reported federally but does not indicate immigration status beyond “noncitizen,” and state-funded enrollments are recorded in state systems that are not harmonized nationally [4] [3] [6].
2. What the state-level evidence does tell us — specific program snapshots
A handful of program-level figures are available and demonstrate substantial but uneven coverage in places that have chosen to expand. California’s phased expansions are expected to cover roughly 700,000 undocumented immigrants under recent policy changes, while Colorado’s OmniSalud enrolled about 10,000 undocumented residents in 2023 with no monthly premium; Washington and other states run premium-assistance or Medicaid-like programs with smaller but meaningful enrollments. These state snapshots show that where states invest, enrollment can be large, but they also reveal that coverage is concentrated in a few states rather than evenly distributed nationwide [2] [3] [6].
3. Federal spending for emergency care gives a partial picture, not a headcount
Between fiscal years 2017 and 2023, federal reimbursements for Emergency Medicaid — the program that covers emergency care for noncitizen immigrants including undocumented people — totaled about $27 billion, accounting for less than 1% of overall Medicaid spending. Emergency Medicaid data illuminate the cost of uncompensated or urgent services but do not provide a headcount of undocumented recipients of full state-funded coverage; the bulk of regular, ongoing coverage for undocumented people is financed and tracked by state programs, not federal claims, making direct translation from Emergency Medicaid dollars to numbers of enrollees impossible [4].
4. Misleading national claims have been debunked — be cautious with headline figures
Recent high-profile claims that “1.4 million undocumented immigrants will be removed from Medicaid” have been fact-checked and found to be misleading or false because undocumented immigrants are not eligible for mainstream federally funded Medicaid; the 1.4 million figure conflated different populations and the impacts of state policy changes. Fact-checks point out that reductions in state-funded programs or changes in federal-state dynamics could reduce coverage for some immigrant families, but the specific figure cited in some political messaging does not match how enrollment and eligibility actually function under current federal rules [5] [1].
5. Bottom line: the most accurate answer and what’s needed next
There is no reliable national total for undocumented immigrants currently receiving state-funded healthcare because reporting is fragmented across states and federal programs track only emergency care for noncitizens. What can be stated with confidence is that several states and D.C. run programs that cover undocumented children and a smaller number cover adults, with notable enrollments in large states like California and smaller targeted enrollments elsewhere; Emergency Medicaid spending quantifies emergency care costs but not routine coverage. A credible national figure would require coordinated, transparent state reporting or a federal effort to standardize and aggregate state-funded coverage data; absent that, any single national number is speculative and unsupported by the available evidence [1] [2] [3] [4].