White House press secretary Karoline Leavitt stirred controversy last week when she criticized “illegal immigrants” that she claimed received “taxpayer-funded health care benefits” for emergency services totalling $9.1 billion in 2024. (1)
Leavitt made the comments during a daily press briefing, accusing the Biden administration of allowing “skyrocketed” Medicaid costs in order to treat undocumented immigrants last year.
Leavitt pressed the point during the briefing, saying, “So when an illegal alien goes to the emergency room, who’s paying for it? The American taxpayer” — using the dehumanizing term for immigrants.
Leavitt also claimed that hospitals were strained by an “increasing number of migrants” and repeated the false assertion that “Democrats want to give taxpayer-funded health care benefits to illegal immigrants” — echoing a talking point that Republicans are saying is to blame for the current government shutdown.
But when you cut through the partisan politics, are American taxpayers actually funding emergency care for undocumented immigrants? Here’s what the data shows.
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The truth about the cost of health care for undocumented immigrants
American taxpayers do help pay for emergency health care provided to undocumented immigrants, but only in limited and legally required circumstances. The costs are also a fraction of what many political figures claim.
Undocumented immigrants qualify for emergency room care under the Reagan-era Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals to stabilize any patient experiencing a medical emergency — regardless of their insurance coverage or immigration status. That means hospitals cannot legally turn someone away in a life-threatening situation, whether they’re a U.S. citizen or not. (2)
So, how much do undocumented immigrants cost U.S. taxpayers each year in medical services? Well, the non-profit Kaiser Family Foundation (KFF) notes that “less than 1% of total Medicaid spending goes to emergency care for noncitizen immigrants.” So, for example, in the year 2023, they showed that of the $860 billion total spent on Medicaid, only .4% of that — or about $3.8 billion — went toward Emergency Medicaid for undocumented immigrants. (3)
And while it’s unclear where Leavitt sourced her $9.1 billion health care price tag, data provided by the non-partisan Institute on Taxation and Economic Policy (ITEP) shows that undocumented immigrants themselves pay more than 10 times that in U.S. taxes — including $96.7 billion in 2022 alone. (4) They account for only a fraction of total U.S. health-care spending — and they pay far more into the system in taxes than they receive in emergency benefits.
Beyond questioning the accuracy of Leavitt’s numbers, critics and reporters also questioned her rhetoric and tone. One journalist asked Leavitt if she believed that hospitals should check a dying patient’s immigration status before treating them, to which she replied, “That’s probably not a question for me to answer. I think that’s a question for healthcare professionals and legal experts to answer.” (5)
Leavitt’s response drew the ire of numerous medical professionals including Seema Jilani, a 20-year doctor, who responded to Leavitt on X by asking, “If your daughter went into cardiac arrest, would you want me to stop and ask for her passport & insurance papers, or would you prefer I start chest compressions and save her life?” (6)
Doctor and CNN medical analyst Jonathan Reiner added that “Requiring ERs to check immigration status before providing emergency care to a dying patient would be grossly immoral and no doctor I know would comply.” (7)
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Why health care is about to get more expensive for American taxpayers
The EMTALA — the only federal avenue for undocumented immigrants to receive emergency care in the U.S. — wasn’t even mentioned in the Republican-led One Big Beautiful Bill Act (OBBBA) earlier this year. (8)
The OBBBA, however, does contain numerous health care overhauls and cuts that are set to dramatically raise the costs of health insurance for millions of American citizens — while stripping some of their coverage entirely.
The ongoing government shutdown was indirectly spurred by the OBBBA, which doesn’t renew ACA extended premium tax credits and makes changes to programs like Medicaid that affect legal U.S. residents.
Democrats are asking Republicans to negotiate reinstating such benefits before re-opening the government but are not in any way — as Leavitt and other Republican colleagues like the president and vice president, claim — seeking to give free health care to undocumented immigrants. (9)
In fact, analyses show that ending ACA extended premium tax credits could dramatically increase health insurance premium costs for more than 20 million low- and middle-income Americans, resulting in 4 million taxpaying Americans losing coverage altogether. Some estimates project insurance premium increases of up to 400%, with older and rural Americans hit hardest.
Additionally, the Congressional Budget Office (CBO) projects that changes to Medicaid rules within the OBBBA will leave 10.5 million fewer Americans eligible for the program by 2034. (10)
For those concerned about losing their health insurance amid rising costs, experts recommend beginning to look at alternative coverage options and possible lower-tier plans, starting (or adding to) a health savings account, using the benefits as much as possible before the tax credits expire at the end of the year and practicing preventative care to minimize your need to dip into your coverage.
So when the question comes up — who’s really paying the bill when undocumented immigrants go to the ER? — the answer isn’t as simple as political talking points suggest. The data shows that undocumented taxpayers are helping fund the same health care system they’re accused of draining.
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Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
Forbes Breaking News (1); CMS (2); KFF (3); Institute on Taxation and Economic Policy (4); C-SPAN (5); @SeemaJilani (6); @JReinerMD (7); Congress.gov (8); MSNBC (9); Congressional Budget Office (10)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.