States Find Few Ineligible Medicaid Recipients After Review

Last August, as part of a broader federal effort to crack down on undocumented individuals, the Trump administration provided states with the names of hundreds of thousands of Medicaid enrollees, instructing them to verify whether those individuals were ineligible due to their immigration status.

However, seven months later, findings from five states shared with KFF Health News suggest that the issue may not be widespread.

Medicaid, along with the Children’s Health Insurance Program (CHIP), provides health coverage to low-income individuals and people with disabilities. These programs are managed by individual states but are limited to U.S. citizens and certain legally present immigrants.

Officials from Pennsylvania and Colorado reported that, as of March, they had not identified any individuals who needed to be removed after reviewing a combined total of 79,000 cases.

In Texas, more than 28,000 records were reviewed, resulting in the removal of 77 individuals, according to a spokesperson from the state’s Health and Human Services Department.

Ohio examined approximately 65,000 enrollees and removed 260 people from coverage, while Utah reviewed around 8,000 cases and terminated benefits for 42 individuals.

When announcing the initiative, Health and Human Services Secretary Robert F. Kennedy Jr. stated that the goal was to strengthen oversight, protect taxpayer funds, and ensure that benefits are reserved for those who meet legal requirements.

However, critics argue the effort was unnecessary. Leonardo Cuello, a researcher at Georgetown University’s Center for Children and Families, noted that states already verify immigration status during the enrollment process.

“It’s entirely predictable that these reviews would yield little,” he said. “States had already done this work, and the federal government simply required them to repeat it, creating inefficiency and wasting resources.”

Federal officials maintain that the process helps confirm eligibility in cases where databases could not initially verify status. States receive regular reports and are responsible for determining eligibility and taking action under federal guidelines.

Data from the reviews also indicate that a large portion of the individuals flagged were actually U.S. citizens. In Ohio, for example, out of 65,000 names provided, 53,000 already had confirmed citizenship, and another 11,000 had valid immigration status. Only about 1,000 required further review.

Federal agencies have not released nationwide results or clarified whether information about individuals losing coverage is being shared with immigration enforcement authorities.

Earlier in June, directives were issued to share certain enrollee data with the Department of Homeland Security, prompting legal challenges from several states concerned about potential use in deportation actions. A federal judge later ruled that immigration authorities could only access data related to individuals without legal status in states that challenged the policy.

While the federal government continues to send updated lists to states, the volume has decreased over time.

Undocumented immigrants remain ineligible for federally funded programs such as Medicaid, Medicare, and Affordable Care Act plans. However, Medicaid does reimburse hospitals for emergency services provided to individuals without legal status, provided they meet income requirements.

Additionally, seven states and the District of Columbia offer health coverage regardless of immigration status using state funds.

In March 2025, federal officials also launched financial audits of these programs, identifying more than $1.8 billion in federal funds to be recovered through voluntary repayments and future payment adjustments.

Total Medicaid spending exceeded $900 billion in fiscal year 2024.