Report: CMS sent states lists of names for impromptu Medicaid eligibility check

President Donald Trump's administration has ordered states to review certain Medicaid enrollees to determine if they are ineligible for insurance coverage due to their immigration status, KFF Health News confirmed in a new report. 

According to the outlet, the Centers for Medicare & Medicaid Services (CMS) sent letters to an unknown number of states, containing the names of individuals the agency suspects are enrolled in Medicaid and whose eligibility under state and federal law is to be double-checked.

KFF said it reached out to the Medicaid departments in 10 states inquiring about the letters. Five states—Colorado, Ohio, Pennsylvania, Texas and Utah—responded, reporting in total that they received roughly 176,000 names.

California, Florida, Georgia, New York and South Carolina either did not respond with any comment or refused to provide specifics on how many individuals CMS declared as potentially illegally enrolled.

Notably, states base their eligibility decisions for Medicaid on federal government records—namely, databases maintained by the U.S. Department of Homeland Security and the Social Security Administration. 

It’s not clear if federal records were wrong, spurring the request, or if state Medicaid workers will just be performing a repeat task. Regardless, the command from CMS creates an administrative burden that will take time and resources to address—and it isn’t clear from the states’ perspectives how much money, if any, can be recovered by an eligibility re-check.

But, CMS Administrator Mehmet Oz, MD, disagrees: In a recent post on X, he accused California, Colorado, Oregon, Washington and Washington, D.C., of collectively misspending nearly $1.4 billion worth of Medicaid funds on people who are not legally permitted to be enrolled. 

He also said that some of the states have begun paying the money back, but no further details were provided. 

KFF Health News pointed out that the context for these numbers was not clear. Unfortunately, CMS did not reply to a request for more details. 

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