While public aid programs like Medicaid and food stamps were originally designed to help out the neediest Americans in brief intervals, those programs have since ballooned dramatically and become used not just by habitual welfare dependents but, as a new study revealed, are riddled with loopholes and lax enforcement policies that have allowed non-Americans to access them.
In fact, as was revealed by the report, which was titled “The Loopholes Fueling Illegal Alien Medicaid and ObamaCare Benefits” and was released by the Foundation for Government Accountability, the loopholes are so large and enforcement so lax that millions of illegal aliens have been able to exploit those programs that were and are meant for needy American citizens.
As the study, conducted by Hayden Dublois and Jonathan Ingram, shows, one of the biggest loopholes available is that of so-called “emergency” Medicaid coverage. As they note, “Although initially created as a narrow safety net to reimburse hospitals for life-saving care provided to illegal aliens, spending on this program has ballooned in recent years.”
Much as could be expected, that spending has become a massive problem over the years as more and more illegal aliens and sanctuary states want to help them take advantage of it, and now, Dublois and Ingram note, “Federal spending on these services nearly tripled over the last five years, reaching an alarming $6.1 billion in 2024.“
Yet worse, the study revealed that most of this spending is coming from California, which received over $4.5 billion last year in reimbursements for “emergency” Medicaid spending on illegal aliens, a whopping 75 percent of the national total. Concerningly, only 16 percent of illegal aliens in the country reside in the Golden State, making its spending on them extremely outsized.
Yet worse, the federal government matches state spending on emergency services for illegals at a far higher rate than it does for the elderly, low-income children, and the disabled. Describing that problem, Dublois and Ingram noted, “In 2024, for example, California received $2.31 in federal funds for every state dollar spent on emergency Medicaid for illegal aliens, compared to just $1.07 in federal funds for every state dollar spent on truly needy enrollees.”
That problem exists because of a quirk with the Affordable Care Act that fails to take even immigration status into account. As they note, “Under ObamaCare, states can claim higher matching rates for able-bodied adults—even when they are in the country illegally and only qualify for emergency services.” Hence the Californian sanctuary state government being reimbursed more for aiding illegal aliens than needy Californians.
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The Trump administration addressed this issue in the “One Big, Beautiful Bill” (OBBB), which closed the match-rate loophole by placing a limit on federal reimbursement for emergency Medicaid for illegal aliens to the state’s normal Medicaid match rate rather than the enhanced one outlined by ObamaCare, thus somewhat blocking the subsidization.
Further, the study illustrates another loophole being used to help illegal aliens take advantage of our nation’s generosity: states can claim federal funding for those who are non-citizens if they are classified as “qualified aliens,” despite not being in the country legally. If an illegal immigrant is granted parole for at least a year, they are then considered “qualified aliens,” despite not having any genuine legal status. That makes them eligible to receive benefits that should only be made available to citizens, despite the fact that parole isn’t even lawful entry.
That became a major problem, as DHS has “authority to temporarily parole aliens into the United States, on a case-by-case basis, for ‘urgent humanitarian reasons or significant public benefit.’” While that’s meant to be temporary and on a case-by-case basis, the study’s authors found that the Biden administration let in three million such aliens who otherwise would have been considered inadmissible.
Doing so, the Biden Administration “automatically granted parole unless certain criteria were met.” Often, that meant that “parole was granted to aliens without application or petition.” As such, millions of otherwise inadmissible aliens were able to access aid programs. Trump attempted to address this through the Big, Beautiful Bill, which excludes most classes of illegal aliens from the program.
Yet worse, the Biden Administration turned what was meant to be a “temporary process for individuals to establish their immigration status . . . into a massive Medicaid on-ramp for illegal aliens.” That would be the “reasonable opportunity period,” or “ROP”. As the authors explain:
Federal law requires states to verify citizenship or immigration status when determining Medicaid eligibility. However, if a state cannot immediately verify an applicant’s stated immigration status, applicants are enrolled in the program and given a reasonable opportunity period (ROP) to prove their status. Reasonable opportunity periods were intended to give applicants time—typically 90 days—to make a good-faith effort to offer proof of citizenship or lawful immigration status.
Working with sanctuary state Medicaid agencies and like bureaucrats that were amenable to providing healthcare for illegal immigrants, the Biden Administration “supercharged these temporary coverage windows by granting unprecedented levels, extending their duration, and renewing them indefinitely.”
Then there is the matter of outright fraud: a huge number of illegal immigrants are also enrolling in Medicaid and other welfare programs through the use of stolen identities. As the authors note, giving an example, “In 2025, a raid conducted by the U.S. Immigration and Customs Enforcement at a single employer identified more than 100 victims of identity theft due to illegal aliens using stolen identities.”
It gets even worse: “Many of those illegal aliens using stolen identities enroll in various welfare programs, including Medicaid, food stamps, public housing, unemployment, or other programs.109-120 Some of those illegal aliens have even been able to use their stolen identities to vote.”
The scale of that appears to be massive. For example, investigators apparently discovered “19 million active SSNs of people over the age of 100 with no death record in the system—including more than 13 million born before the world’s oldest living person.” And those persons are active, not just miscounts: “Billions of dollars in wages are reported for these individuals each year.” The BBB aimed to fix this as well.
Watch a video put out by the White House calling out Democrats for this disastrous state of things:
While the OBBB has done a remarkable job of slowing down the flow of Medicaid and ObamaCare funding to illegal immigrants, the fight to protect our most vulnerable citizens is far from over. Now the battle is being waged over the repeal of these necessary reforms, which Democrats are demanding to end the current government shutdown. If Democrats force Republicans to capitulate, it could do immense damage to the disabled, the elderly, and low-income children across the country.