Nov 1, 2025 2 min read

The Trump administration and Congressional Republicans have been known to lose their already tenuous grip on the facts from time to time. The latest example being their repeated declaration that large numbers of undocumented immigrants have been allowed to enroll in Medicaid.

House Speaker Mike Johnson stated recently that “illegals are draining the resources from Medicaid” and challenged listeners to fact check his claim through the Congressional Budget Office (CBO).

Challenge accepted, but first the facts.

Undocumented immigrants are barred from enrolling in Medicaid by the Personal Responsibility & Work Opportunity Act of 1996. However, this act does allow for qualified immigrants such as those granted asylum and refugee status, green card holders and other non-citizen groups to become enrolled.

Undocumented immigrants can receive treatment for medical emergencies at Medicaid-funded hospitals through the Emergency Medical Treatment and Labor Act of 1986. Emergency services include medical screening and stabilizing treatment to anyone with an emergency medical condition regardless of their ability to pay or their immigration status.

Perhaps this is the policy that is filling Speaker Johnson with such dread.

Yet, even President Ronald Regan, who signed both of these acts into law, appreciated the prospect that preventing people – even undocumented immigrants – from receiving badly needed emergency medical care would be too inhumane and would poorly reflect our country’s values.

And what say the CBO? Just $37 Billion over six years.

That amount represents all federal and state spending on emergency medical support for non-U.S. citizens throughout the country from 2017 to 2023. That equals less than 1% of total Medicaid spending for that period. Let that sink in.. less than 1%. Hardly a substantial drain on our nation’s resources.

So remember: No undocumented immigrants are being enrolled in Medicaid programs. But undocumented immigrants – the people who significantly help rebuild our towns and cities after hurricanes and wildfires, pick our crops, tidy our landscaping, work in our meat packing houses and fix our roofs – are humanely provided with emergency medical care.

I would like to think that even Speaker Johnson, a noted Christian evangelical, would be comfortable with that.

John Carnahan

Canonsburg