Illegal aliens now have an on-ramp to Medicaid – as many as 22 million of them. 

This budding crisis is a major danger to our health care system and American taxpayers. It’s the direct result of the Biden-Harris administration’s immigration and welfare policies and will surely worsen if Kamala Harris wins in November.

The Biden-Harris White House is shattering a system that was already cracking. My organization recently submitted state freedom of information requests on the number of Medicaid applicants who can’t prove their citizenship status yet receive coverage anyway. 

Migrants walk along the highway through Suchiate in southern Mexico, July 21, 2024, during their journey north toward the U.S. border. (AP Photo/Edgar H. Clemente)

When people apply, states typically check their citizenship status with the federal sources, but if the data doesn’t match, states give applicants a 90-day grace window, known as a "reasonable opportunity period" to collect documentation. 

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This system wasn’t prepared for the Biden-Harris administration’s dangerous combination of lax border enforcement, welfare expansion and lack of concern for welfare program integrity. Only nine states meaningfully responded to our request, including Arizona, Kentucky, Missouri, Texas and Wisconsin. Some states, like Pennsylvania and Michigan, claimed they had no records at all, while others, like California, demanded exorbitant fees to access the records. 

Regardless, the nine responsive states showed that between 2019 and 2023, the number of illegal aliens on Medicaid grew by 500%. The expense to taxpayers has also soared. In the five states that provided financial information, taxpayers forked over nearly 550% more to cover illegal aliens. Across all 50 states, it’s likely that at least 100,000 ineligible aliens are on Medicaid, potentially costing at least a billion dollars a year. 

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These numbers are rising quickly because more illegal aliens are applying for welfare, a direct response to Biden-Harris border and welfare policies. States are also routinely extending the reasonable opportunity periods beyond 90 days. 

Across all people receiving grace coverage on the taxpayer’s dime, the number of people who stayed on Medicaid after three months soared by nearly 50% between 2019 and 2023.

In Kentucky, under Democratic Gov. Andy Beshear, the number of individuals receiving Medicaid coverage while the state unsuccessfully tried to verify their citizenship grew from zero in 2019 to nearly 2,400 in 2024. Arizona’s situation has also worsened under Democratic Gov. Katie Hobbs.

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But the Biden-Harris administration has ensured that the worst is yet to come. The U.S. Department of Health and Human Services has issued a new federal regulation, effective as of June, that prohibits states from limiting extensions to reasonable opportunity periods. 

Once the 90 days end, the state is no longer empowered to stop them from getting another grace period. In other words, illegal aliens who apply for Medicaid can be put on the program for never-ending 90-day windows as long as they claim they are making an "effort" to prove their citizenship.

While there’s no hard data yet on how many are taking advantage of the Biden-Harris loophole, the incentives are clear and the deluge inevitable. California already extends Medicaid coverage to illegal aliens at an annual cost of about $4 billion.

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Nationwide, taxpayers could soon be paying tens of billions of dollars on health care for people who have no right to our safety net—including those who have no right to be in the country.

All of health care will suffer, too. Medicaid pays much less than private insurance, so burdening hospitals with illegal aliens will lead to mounting red ink. Some hospitals have already closed, especially in states that expanded Medicaid under ObamaCare, and covering illegal aliens will likely cause more to follow suit. 

Sen. JD Vance recently noted that "we're bankrupting a lot of hospitals by forcing [them] to provide care for people who don't have the legal right to be in our country," a reality that’s getting worse by the day. And for every illegal alien who accesses health care, Americans get pushed back in line.

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This is surely the biggest handout to illegal aliens in American history. As the word spreads, it may encourage an even bigger rush at the southern border. 

After watching the Biden-Harris administration lay the groundwork for this crisis over the past four years, Americans would be wise to ask: Is this actually what Kamala Harris wants?

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