A cross-sectional analysis of emergency Medicaid expenditures from data in the 2022 Medicaid Budget and Expenditure System found that of the 38 states plus Washington, DC, was nominal compared to overall spending.

There are confounders. Not all states allow it and 11 did not report emergency Medicaid spending on illegal immigrants and some, like California, now give health care for free to anyone regardless of their legal status, which means the $9 billion on emergency room care for illegal immigrants in 2024 is 70% due to that one state. Total Medicaid costs for illegal immigrants during 2021-2024 were $16 billion but this paper did not include other public spending.




$9 billion is less than 1% of overall Medicaid spending. The interest on US debt alone is nearly as high as Medicaid spending so cuts to Medicaid in the amount of 1% makes a nominal difference in the burn rate of the federal government. The real issue is that the Affordable Care Act (ACA) was invoked to address the 700,000 people who had too much income for Medicaid but private health care companies refused to insure due to risk. Yet by 2024 the number of people covered by ACA was up to 50,000,000 being subsidized. That illegal immigrants have more money spent on them per capita in California than citizens get is a political talking point, but obviously what Californians want.  Yet at least 36 other states don't want to pay for California good works.

Europe is in a similar panic about the cost of its social services. Their solution is to make citizenship very difficult to get. An illegal immigrant who saved a French child was rewarded with citizenship in France. That is basically what you have to do if your parents were not French. There was no other way he wouldn't have been deported had he been caught otherwise.