Last August, as part of the federal government’s crackdown on people in the country illegally, the Trump administration sent the names of thousands of people enrolled in Medicaid to states with orders to determine whether they were ineligible based on immigration status.
But seven months later, findings from five states shared with KFF Health News show that the reviews have revealed little evidence of a widespread problem.
Only U.S. citizens and some lawfully present immigrants are eligible for Medicaid, which covers health care costs for low-income and disabled people, and the closely related Children’s Health Insurance Program. Both programs are administered by states.
As of March, the states had found no one who needed to be removed from Medicaid, spokespeople for Pennsylvania and Colorado’s Medicaid agencies said. This was after checking a total of 79,000 names.
Texas has reviewed the records of more than 28,000 Medicaid enrollments at the request of the Trump administration and ended coverage for 77 of them, according to Texas Department of Human Services spokeswoman Jennifer Ruffcorn.
Ohio has screened 65,000 Medicaid enrollees, removing 260 of them from the program, said Stephanie O’Grady, spokeswoman for the Ohio Department of Medicaid.
In Utah, 42 of the 8,000 enrollees identified by the Trump administration had their Medicaid coverage terminated, said Becky Wickstrom, spokeswoman for the state Department of Workforce Services.
Announcing the reviews, Health and Human Services Secretary Robert F. Kennedy Jr. said: “We are tightening enrollment oversight to protect taxpayer money and guarantee that these vital programs serve only those who are actually eligible under the law.”
Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families, said the review ordered by the federal Centers for Medicare and Medicaid Services was unnecessary because states check immigration status when people sign up.
“It is entirely conceivable that the burdensome reviews the federal government is imposing on states will result in no wage payments,” Cuello said. “States had already reviewed once, and CMS was having them re-verify the same information they had already reviewed. Making states go through the same bureaucratic process twice is incredibly wasteful and inefficient.”
CMS spokesperson Chris Krepich said in a statement to KFF Health News that the ongoing investigation is “confirming eligibility for some enrollees whose status could not be confirmed through federal data sources.”
“CMS provides regular reports to states for follow-up review, and states are responsible for independently confirming eligibility and taking appropriate actions consistent with federal requirements,” he said.
But the findings shared with KFF Health News also show that many of the enrollees whose eligibility the Trump administration said it could not verify are actually U.S. citizens. O’Grady said Ohio found that of the 65,000 names referenced by the federal government, the state already had information about 53,000 confirming them as citizens and about an additional 11,000 that showed proper immigration status for Medicaid.
Caseworkers worked on the remaining 1,000 names to review their information or access more details, he said.
CMS did not respond to questions about the findings from states sampled by KFF Health News or provide information about the responses it received from all 50 states and the District of Columbia, which were instructed to conduct the verification investigation.
The agency also did not answer questions about whether it was sending the names of people whose Medicaid coverage was terminated to federal immigration authorities.
In June, Kennedy advisers ordered CMS to share information about Medicaid enrollees with the Department of Homeland Security, prompting a lawsuit from some states, raising concerns that the administration would use the information for its deportation campaign against residents living in the US without authorization.
a federal judge ruled in december Immigration and Customs Enforcement officials can only obtain information about people in the country illegally in the Medicaid databases of the states that filed the lawsuit.
CMS continues to send lists of names to states at least every few months, though state officials say the number has declined since the first batch last summer.
People without legal status are ineligible for federally funded health coverage, including Medicaid, Medicare, and plans through the Affordable Care Act Marketplace. Medicaid reimburses hospitals for providing emergency care to people without legal status if they meet income and other program requirements.
Seven states and the District of Columbia provide health coverage regardless of immigration status, financing the programs with their own money.
In March 2025, CMS began a financial review of those programs. “CMS has identified more than $1.8 billion in federal funds that are being recovered through voluntary returns and deferral of future federal Medicaid payments,” Krepich said. He did not answer how much has been collected so far and from which states.
Total Medicaid spending exceeds $900 billion in fiscal year 2024.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of KFF’s core operating programs – an independent source of health policy research, polling and journalism. learn more about KFF.
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