Mazie Hirono and Chuck Schumer with Spam. (The Office of Mazie Hirono)
Washington is once again at a standstill, but this shutdown is not about budget math or routine partisan squabbles.
At its core, the fight centers on one question that should be obvious: Should Medicaid, a safety-net program designed for low-income Americans, be stretched to cover illegal immigrants?
Democrats have answered yes, Republicans no—and the standoff has left taxpayers caught in the middle.
The fight began with the passage of the Big Beautiful Bill earlier this year. One of its most important provisions closed a Medicaid loophole that allowed states to pass the cost of illegal immigrant health care onto federal taxpayers.
WATCH: Medicaid for Illegal Aliens Is ROBBING U.S. Taxpayers Blind
That reform required states to fund those services themselves instead of exporting the bill nationwide.
Democrats are now demanding that this provision be undone, and their refusal to compromise has kept the shutdown going.
California illustrates how large the abuse has become.
In 2023, the state set aside $3.9 billion in Medicaid funds for medical services for illegal immigrants.
Because the federal government typically reimburses around 70% of Medicaid spending, taxpayers across the country ended up footing most of that bill.
To squeeze even more money from Washington, California raised provider taxes on hospitals and nursing homes, then cycled the revenue back through inflated Medicaid payments.
On paper, the state appeared to spend billions more. In reality, it was a budgetary trick designed to capture federal dollars and shift costs to the rest of the country.
New York followed the same playbook, allocating $2.4 billion in 2024 to extend full Medicaid benefits to illegal immigrants under 65.
Illinois expanded coverage to noncitizens over 42.
The strategy is consistent: inflate Medicaid spending, collect federal reimbursements, and redirect money to people who are not legally eligible.
Citizens in states like Texas, Florida, and Ohio never voted for these policies, yet their tax dollars are used to finance them.
At the same time, Medicaid itself is weighed down by fraud and waste. Federal data show at least five million ineligible people remain enrolled.
Improper payments cost about $30 billion every year and have totaled more than $1.1 trillion over the past decade.
Between 2019 and 2021 alone, insurers collected $4.3 billion in duplicate payments for people enrolled in multiple states.
The Big Beautiful Bill targeted these exact abuses by tightening eligibility checks, banning the recycling of provider taxes, and enforcing stricter reporting standards.
The goal was straightforward: preserve Medicaid for citizens and legal residents who qualify—not expand it into a hidden subsidy for those who broke immigration law.
Democrats insist they are “defending health care.”
The reality is they are defending Medicaid access for illegal immigrants at a time when the program already costs more than $800 billion a year.
Protecting taxpayers and preserving Medicaid’s integrity should be the priority. Instead, Democrats have chosen to keep Washington closed until those benefits are restored.
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