By withholding key waivers, the administration could discourage bad behavior.
Last week, President Donald Trump issued an executive order barring illegal immigrants from accessing welfare benefits. His action opens the door to a thorough reevaluation of how the federal government treats states that give generous benefits to unlawful residents.
In particular, the Department of Health and Human Services should stop approving Medicaid waivers for states that provide free health insurance for illegal aliens. Following President Trump’s order, Health & Human Services secretary Robert F. Kennedy Jr. should sunset key Medicaid waivers to states, such as New York and California, that cover illegal migrants.
To achieve President Trump’s goal, Kennedy would rely on an often-overlooked policy mechanism: waivers issued under Section 1115 of the Social Security Act. These waivers grant states special permission to expand or restrict Medicaid eligibility beyond standard federal requirements. That lets states experiment with ways to reduce costs or improve care, like imposing work requirements on welfare recipients.
States have also used Section 1115 waivers to bypass federal eligibility guidelines—including those that prohibit coverage of illegal immigrants. Fourteen states now offer Medicaid or Children’s Health Insurance Program benefits to at least some people living in the United States illegally, and 12 of those states have an approved Medicaid waiver. Five states with waivers cover illegal immigrants of all ages and categories.
State dollars fund Medicaid coverage for illegal migrants, not federal subsidies. But while states have the right to use their budgets as they please, the federal government is equally free to withhold additional flexibility that states request under Medicaid waivers, and to let preexisting waivers expire, until they bring their spending into alignment with federal priorities.
Such a shift would have multiple positive effects. First, it would deter additional Democrat-led states from using state funds to cover illegal immigrants under Medicaid. Second, if these states stop covering them, some illegal immigrants would self-deport or find more productive jobs.
Finally, ending some waivers would reduce the burden on federal taxpayers, who foot much of the bill for expanded Medicaid coverage under the (non-immigration-related) waivers. To ensure savings, HHS should sunset only waivers that expand Medicaid eligibility, rather than those that restrict it. California’s waiver, for example, allowed the state to disregard the maximum-assets ceiling to qualify for Medicaid, and Illinois received a waiver allowing reinstatement of Medicaid coverage even in cases where paperwork is submitted months late.
Critics will argue that millions of innocent people will suffer or even die if the government doesn’t take care of them. But Medicaid coverage of illegal immigrants is a new phenomenon. Even California didn’t do it until after the Covid-19 pandemic, and illegal immigrants have lived there for decades. At least one study even found that Medicaid coverage has no significant effect on health outcomes, though it did increase health care use and spending. Pressuring states to revert to their previous policies is about restoring common sense and being a good steward of taxpayer dollars.
Sunsetting these Medicaid waivers would protect federal and state taxpayers from footing the bill for state expansions and discourage states from handing out welfare to illegal immigrants. While some Trump immigration policies remain contentious, not giving welfare to illegal immigrants is nearly universally popular. It’s time to align one of the largest federal welfare programs with the president’s agenda by preventing it from becoming a magnet for unauthorized migration.
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USDA Secretary moves to withhold food stamps from illegal immigrants
“It is essential we use all available legal authority to end any incentives in FNS benefit programs that encourage illegal immigration.”
US Department of Agriculture Secretary Brooke Rollins on Tuesday announced that she has directed officials to carry out Trump’s executive order barring illegal immigrants from receiving taxpayer benefits, including food benefit programs.
In a letter addressed to “state, Tribal, Territorial, and Local Government Partners,” Rollins wrote that she was “committed” to fulfilling Trump’s executive order titled “Ending Taxpayer Subsidization of Open Borders.”
“The Food and Nutrition Service (FNS) at the US Department of Agriculture plays an important role in providing nutrition services to vulnerable populations in the interest of our Nation. Program eligibility rules are determined by Congress. In 1996, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act” which “generally prohibits illegal aliens from receiving Federal benefits, including Supplemental Nutrition Assistance Program (SNAP) benefits,” Rollins wrote.
“With its enactment, illegal aliens in the United States should not depend on taxpayer dollars to take care of their needs. President Trump’s Executive Order reaffirms this important national policy—and puts the needs of Americans first,” she continued. “It is essential we use all available legal authority to end any incentives in FNS benefit programs that encourage illegal immigration. The President has made clear the status quo is not acceptable.”
Rollins wrote that she has directed senior staff at FNS to “review the public benefit programs it administers at the Federal level to ensure alignment with the President’s Executive Order,” and that after the review, “FNS will implement necessary changes so all its programs are consistent with Federal law, including PRWORA.”
“FNS will also work to revise public messaging so that information about program eligibility is accurate and does not encourage illegal aliens to use public benefit programs. Furthermore, FNS will take measures to improve eligibility verification and deter fraud.”
Under the prior Biden administration, the Department of Agriculture directed state agencies and Food and Nutrition Act program operators to “expeditiously review their program discrimination complaint procedures and make any changes necessary to ensure complaints alleging discrimination on the basis of gender identity and sexual orientation are processed and evaluated as complaints of discrimination on the basis of sex,” a 2022 memo stated.
The USDA wrote on its website that it “will interpret the prohibition on discrimination based on sex found in Title IX of the Education Amendments of 1972, and in the Food and Nutrition Act of 2008… to include discrimination based on sexual orientation and gender identity.” To receive federal funding for school lunches under this, they were required to change their state-specific non-discrimination statements to include sexual orientation and gender identity language. The 11th Circuit Court of Appeals blocked the Biden-Harris administration’s interpretation of Title IX of the Civil Rights Act in August.
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