Florida’s Medicaid program has experienced a dramatic decrease in spending on emergency health care for undocumented immigrants following the implementation of a controversial immigration law signed by Republican Governor Ron DeSantis. This shift comes as part of a broader crackdown on illegal immigration in the state, coinciding with DeSantis’ unsuccessful bid for the Republican presidential nomination.
The law, which took effect in July 2023, requires hospitals accepting Medicaid to inquire about patients’ immigration status during treatment. While patients are not obligated to respond, immigrant rights advocates feared this mandate would deter migrants from seeking urgent medical care. The DeSantis administration and Florida Republicans view the subsequent decline in spending as evidence of the law’s effectiveness.
A POLITICO analysis reveals that Florida’s Emergency Medical Assistance program for undocumented immigrants has seen a striking 54% reduction in Medicaid-billed expenditures since the law’s implementation. With less than two months remaining in the fiscal year, this significant drop has caught the attention of policymakers and healthcare experts alike.
Thomas Kennedy of the Florida Immigrant Coalition noted that while there’s no concrete evidence directly linking the spending decrease to the new law, other indicators suggest a broader impact on the state’s immigrant population. “Obviously, there’s been somewhat of an exodus of migrants in Florida,” Kennedy stated, referencing warnings about potential workforce shortages and industry distress that were raised when the legislation was being considered.
Federal law prohibits undocumented immigrants from general Medicaid eligibility but requires states to provide limited coverage for migrants facing medical emergencies, such as dialysis, childbirth, or trauma. Data from the Florida Agency for Health Care Administration and the U.S. Department of Health and Human Services show that in the year preceding the new law, $148.4 million in state and federal Medicaid funds were allocated for emergency coverage of immigrants in Florida. As of May 3 in the current fiscal year, that figure stands at $67 million, projecting a significant annual decrease despite two months remaining.
This sharp decline represents an acceleration of a pre-existing trend. In the 12 months before the law’s enactment, Medicaid expenditures had already dropped by about 13%, from $171.4 million in 2022 to $148.4 million in 2023.
Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families, highlighted that approximately half of the Emergency Medical Assistance spending goes toward pregnant women in labor. He expressed concern about the potential long-term consequences of the state immigration law, suggesting that it might lead women to avoid hospitals during childbirth.
The DeSantis administration maintains that the state’s healthcare system prioritizes legal U.S. citizens while still ensuring treatment for those with medical necessities. Alecia Collins, a spokesperson for the Agency for Health Care Administration, emphasized that the Medicaid expenditures represent only a portion of the financial burden illegal immigration places on the state’s hospital system.
An AHCA report published in March determined that hospitals were left to cover more than $566 million in unpaid medical bills from undocumented patients in the last six months of 2023. However, this report has faced criticism from experts who question the methodology used to arrive at this figure.
The impact of the immigration law on healthcare access first emerged in February when the Mexican Consulate in Orlando noticed a decrease in participation in a free health screening program for women. Republicans interpreted this as a sign of the law’s success in discouraging migrants from remaining in the state.
Some Republican lawmakers have expressed concerns about the law’s potential impact on the state’s agriculture industry, which heavily relies on migrant labor. State Rep. Rick Roth (R-West Palm Beach) was reported to have asked for help in convincing workers to stay in Florida, highlighting the complex economic implications of the new policy.
As Florida continues to grapple with the effects of this immigration crackdown, the debate over its impact on healthcare access, state finances, and the broader economy is likely to intensify. The significant drop in Medicaid spending on undocumented immigrants represents a major shift in the state’s approach to healthcare and immigration, with potentially far-reaching consequences for Florida’s diverse communities.
Politico.com