Emergency Medicaid for undocumented immigrants accounts for less than 1% of state spending: Study
Emergency spending amounted to about $9.63 per resident.
October 9, 2025
A recent study reveals that Emergency Medicaid for undocumented immigrants constitutes only 0.4% of total Medicaid spending in 2022, highlighting a significant underestimation of its impact. Researchers from Emory University, the University of Colorado Anschutz Medical Campus, and Harvard T.H. Chan School of Public Health analyzed financial management report data for the fiscal year 2022 from the Medicaid Budget and Expenditure System.
The study found that emergency Medicaid spending for undocumented immigrants averaged approximately $9.63 per resident in 38 states and Washington, D.C. This finding challenges the notion that the 2025 Budget Reconciliation law's cuts to Medicaid will only affect care for groups deemed ineligible, such as undocumented immigrants. Critics argue that this perspective overlooks the critical role of Emergency Medicaid in providing essential medical care to those who meet Medicaid requirements except for U.S. citizenship or legal immigration status.
Emergency Medicaid, a limited form of Medicaid, covers immediate, short-term medical treatment, including labor and delivery. Some states also include care for conditions like dialysis and cancer treatments. Even in states with the largest undocumented populations, costs remained under 1% of Medicaid budgets, though these states spent roughly 15 times more per person than those with smaller undocumented populations.
The authors caution that cutting emergency Medicaid, as proposed in the 2025 Budget Reconciliation law, would yield minimal savings and disproportionately harm safety-net hospitals and clinicians serving immigrant communities. They emphasize the study's limitations, including the absence of data from 11 states and the exclusion of other public spending on undocumented immigrants, underscoring the need for a comprehensive approach to understanding the true impact of Emergency Medicaid.
