January 11, 2024

Cassidy Leads Reintroduction of Legislation to Prevent Liberal States from Forcing Americans to Subsidize Free Health Care for Illegal Immigrants

WASHINGTON – U.S. Senator Bill Cassidy, M.D. (R-LA) led U.S. Senators Marsha Blackburn (R-TN), Roger Wicker (R-MS), Cindy Hyde-Smith (R-MS), and John Barrasso (R-WY) in introducing the Protect Medicaid Act to ensure the long-term integrity of Medicaid by preventing liberal states like California from forcing American citizens in other states to subsidize state programs that expand Medicaid benefits to illegal immigrants. The bill prohibits federal money from being spent on administering state Medicaid benefits paid for by American citizens to noncitizens. If a state chooses to give Medicaid benefits to illegal residents, the bill ensures that state does so entirely on its own dime, without any costs to taxpayers in other states.

“Medicaid for migrants is a magnet for more illegal immigration,” said Dr. Cassidy. “This is terrible public policy for California citizens who depend on Medicaid, middle-class families paying taxes, and state debt. Taking care of the most vulnerable Americans should be our priority. Attempting to provide health care to everyone around the globe for free is not possible or feasible. Compassion that cannot be sustained is not compassion.”

“Tennesseans and the American people do not want their tax dollars subsidizing Medicaid for illegal immigrants,” said Senator Blackburn. “Not only is it unfair to hardworking citizens, but it incentivizes more illegal immigration and puts the care of millions of Americans on the back burner.”

“There is a crisis at our southern border, and the solution cannot be to reward bad behavior,” said Senator Wicker. “Mississippians are already feeling the pain in their own pocketbooks. The last thing they want is to subsidize an illegal immigrant’s journey to the United States.”

“California and other liberal states have gamed the system for years to provide Medicaid to illegal immigrants, which is against the law and forces Mississippi taxpayers to foot some of the bill.  The Biden border crisis and liberal policies are making the situation worse and more costly,” said Senator Hyde-Smith. “This bill is an attempt to stop the abuse of the Medicaid program and force liberal states to carry the burden of their choice to give Medicare benefits to noncitizens.”

Federal law already bars illegal immigrants from receiving Medicaid, but states like California get around federal law by using state funds to extend Medicaid benefits to illegal immigrants. Of course, this would be less financially feasible if the state did not already receive millions of dollars from the federal government.

California already discourages doctors from seeing new Medicaid patients by reimbursing them at the third lowest rate in the nation. This means Medicaid patients have a harder time getting appointments and receiving care. And like every state, California faces a shortage of Primary Care Providers. As of November 2023, before California expanded Medicaid eligibility to illegal immigrants, the state needed 1,430 additional Primary Care Providers to meet the current need. California has 694 designated Primary Care Health Professional Shortage Areas, which is by far the highest in the country. The next highest state has 436 shortage areas.

On top of its $68 billion budget deficit, California estimates that guaranteeing free health care for illegal immigrants in the state will cost the state more than $3 billion annually. In addition to California, Oregon also guarantees Medicaid coverage to illegal immigrants. 

The Protect Medicaid Act also requires the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) to review and report on:

  • How states that provide Medicaid services to illegal immigrants keep federal and state dollars separate.
  • Whether states providing health benefits to illegal immigrants use gimmicks that rip off the federal government, like provider taxes and intergovernmental transfers, to launder federal dollars to offset the cost of providing benefits to this population.
  • Whether people in the country illegally benefit from covered outpatient drugs purchased under the Medicaid Drug Rebate Program and the 340B program, and whether this impacts the prices American citizens pay.


Last week, Cassidy discussed the many issues associated with Medicare for illegal immigrants on Fox News’ America’s Newsroom. Watch the segment here.

Cassidy last introduced this bill in January 2019 to prevent taxpayer resources from paying for free health care for illegal immigrants.