During the six weeks of the government shutdown, which could end soon, President Donald Trump has repeatedly claimed, falsely, that Democrats “want $1.5 trillion for health care for illegal immigrants.”
The $1.5 trillion is the total estimated 10-year cost of the spending bill Democrats introduced at the start of the shutdown. As we’ve written before, Democrats have sought an extension of the Affordable Care Act’s enhanced subsidies and the repeal of some Medicaid-related health care measures in the One Big Beautiful Bill (OBBBA), among other funds.
Democrats also want to restore health care for “lawfully present” immigrants affected by OBBBA.
Lawmakers are close to reaching a deal to end the government shutdown, with the Senate approving a procedural vote on Nov. 9. The closure began on October 1.
Trump has made the $1.5 trillion claim many times. For example, in an Oct. 19 interview with Fox News’ Maria Bartiromo, Trump said, “They want $1.5 trillion for health care for illegal immigrants coming to our country.”
In his Nov. 2 interview with “60 Minutes,” the president said the money would go to “prisoners and drug dealers” and people “who came to our country from mental institutions.” On November 7, he said again: “We are not going to give $1.5 billion to people who came to our country illegally.”
That claim is “totally false,” Leonardo Cuello, a research professor at the Center for Children and Families at Georgetown University’s McCourt School of Public Policy, told us in a telephone interview.
“The legislation that Democrats are defending as a requirement to reopen the government would cost about $1.5 trillion over 10 years, but the vast majority of that is not because of immigration, much less because of ‘illegal immigrants,’” Kent Smetters, academic director of Penn Wharton’s Budget Model, told us in an email.
“In fact,” he said, “current spending on undocumented workers each year is less than $5 billion, primarily due to solely emergency care that is not reimbursed and therefore absorbed by Medicaid. These services cover labor and delivery, trauma, and other urgent conditions.”
Under federal law, hospitals are required to provide emergency medical care to people regardless of their immigration status.
Before Trump began making the false claim in mid-October that Democrats wanted to spend $1.5 trillion on health care for “illegal immigrants,” the White House had released a memo stating that the Democrats’ proposal “would result in nearly $200 billion spent on health care for illegal immigrants and other noncitizens over the next decade.”
That is misleading, but the reference to “non-citizens” is defensible.
That claim is based largely on the Democratic proposal to repeal parts of the OBBBA, recently renamed by the Trump administration as the Working Families Tax Cuts Act. Some of those provisions refer to immigrants who are “lawfully present.” The term refers to noncitizens with “qualified” immigration status that makes them eligible for Medicaid or the Children’s Health Insurance Program, as health policy organization KFF explains. This includes legal permanent residents, refugees, people on parole or temporary leave, and people who have been granted asylum, among others.
Julia Gelatt, associate director of U.S. immigration policy at the nonpartisan Migration Policy Institute, told us for a previous article that the term “lawful presence,” “is not a fully defined category in immigration law,” and is “a politically controversial categorization.”
The OBBBA changed the criteria for Medicaid enrollment to exclude those granted asylum and temporary parole.
But these provisions do not affect the access of people who are in the country illegally, Cuello told us. Immigrants living in the country illegally are prohibited by law from receiving federally funded comprehensive coverage.
Whether or not the OBBBA health care changes are repealed, “it does not imply any change in coverage for undocumented immigrants,” Cuello said
The OBBBA also limited federal matching funds used to reimburse hospitals that provide emergency care to immigrants. Democrats proposed repealing it. This provision “is at least related to undocumented immigrants, but it doesn’t actually affect coverage,” Cuello explained in a blog on October 2. “Hospitals still have to provide the medical care and states still have to pay them for it — it’s just that the federal government will pay a smaller share of the cost.”
When we asked the White House for evidence to support the president’s claim, spokeswoman Abigail Jackson first sent links to the memo that listed nearly $200 billion ($193 billion) for “health care for illegal immigrants and other noncitizens.”
When asked about the president’s $1.5 trillion claim, Jackson said, “President Trump is right: Instead of supporting the bipartisan CR (continuing resolution) that they supported 13 times during the Biden administration, Democrats proposed a $1.5 trillion CR (continuing resolution) to provide free health care to undocumented immigrants. This absurdly partisan maneuver is the reason Americans are now not receiving their paychecks and benefits. Democrats should reopen the government “immediate.”
But, as we said, the $1.5 trillion is the 10-year total of the entire funding bill.
“The (White House’s) original value of $193 billion is certainly reasonable, if applied to legal immigration,” Smetters said. The figure of “1.5 trillion dollars is incorrect, applied to any type of immigration, legal or not.”
(Translation edited by Catalina Jaramillo)
