Health Experts Dispute CMS Administrator’s Claims on Immigrant Medicaid Spending

Medicare and Medicaid Services (CMS) Administrator Mehmet Oz recently sparked controversy when he claimed on social media that “more than $1 billion of federal taxpayer dollars were being spent on funding Medicaid for illegal immigrants.” However, healthcare policy experts have challenged these assertions, explaining that the audits Oz referenced were routine administrative reviews unrelated to immigration status.

Leo Cuello, a research professor at Georgetown University’s Center for Children and Families, noted that based on available information, the audits appear to be standard reviews of “administrative errors in state claiming for matching funds,” which he described as “a relatively common occurrence” that CMS routinely monitors.

“States are constantly sending CMS claims, and CMS is constantly reviewing whether or not they’re paying something properly,” Cuello explained. He cited examples like states requesting federal reimbursement for programs meant to be state-funded, such as Meals on Wheels. Reports from Oregon Live and KFF have confirmed these audits were indeed routine financial reviews.

What stands out as unusual, according to Cuello, is a CMS administrator publicly commenting on these routine audits in political terms. In his post on X (formerly Twitter), Oz linked the audit findings to the ongoing government funding debate, claiming: “Democrats are demanding the repeal of the President’s Working Families Tax Cuts legislation in order for their votes to reopen the government. This law wisely strengthened our ability to limit federal dollars from being spent on health care for illegal immigrants.”

Cuello challenged this characterization, saying Oz was “mixing apples and oranges” by connecting unrelated issues—routine audits with legislative battles over the One Big Beautiful Bill Act, Affordable Care Act tax credits, and government funding. He emphasized that Republicans’ proposed cuts would primarily affect U.S. citizens, not undocumented immigrants.

Nina Yamanis, a professor at American University’s School of International Service, called Oz’s $1 billion claim “highly unlikely” given the strict eligibility verification processes for Medicaid. “I can’t imagine you could get on Medicaid while undocumented,” she said, explaining that when verifying eligibility, “if a lawful resident does not have a Social Security number, the state confirms their legal status by checking a database from homeland security, as well as verifying specific immigration documents.”

Cuello added perspective to the disputed figure, noting that even if accurate, “$1 billion is about one-tenth of 1% of the trillion dollars that was cut out of the Medicaid program, and those cuts target U.S. citizens.”

Healthcare experts worry that such rhetoric, regardless of its accuracy, contributes to a climate of fear that discourages immigrant communities from seeking necessary medical care. Yamanis shared that she’s heard accounts of lawfully present immigrants in North Carolina avoiding newly available Medicaid expansions out of fear of system repercussions, despite being eligible after completing the required five-year waiting period.

The implications of such fear extend beyond immigrant communities. Yamanis pointed to increasing HIV infection rates among Latinos over the past decade, attributing this trend to “access to healthcare, language barriers, fears of deportation and also immigration status.” She warned that when people avoid testing or treatment due to these fears, “it’s problematic, because that means that HIV is spreading among all of us.”

The situation is particularly concerning for vulnerable groups like gay men and transgender women who are immigrants, Yamanis noted. Many fled discrimination and violence in their home countries, making “the threat of deportation much worse for that community” and further deterring them from seeking essential healthcare.

The CMS did not respond to requests for comment on Administrator Oz’s statements.