Democrats claim the Medicaid cuts in President Donald Trump’s One, Big, Beautiful Bill (OBBB) are “cruel” and will kill people. Yet all 50 states collectively spend an estimated $182 billion annually on illegal immigrants—most of it driven by Democrat-led sanctuary policies. That money could easily cover the very Medicaid gaps they claim to care so deeply about
The OBBB doesn’t slash Medicaid out of spite—it promotes accountability. Signed on July 4, 2025, the bill shifts responsibility to the states, curbing runaway spending and capping the federal match. If a state wants to expand Medicaid, it must fund the expansion itself—not rely on taxpayers in other states to foot the bill.
Illegal immigrants receive far more than emergency services. Across the country, they’re provided with taxpayer-funded healthcare, housing, food, hotel stays, legal representation, in-state college tuition, prepaid debit cards, direct cash payments, flights, bus rides, and more. These costs hit every state—whether through federally mandated emergency services or extravagant, state-funded benefits in left-wing strongholds. It’s no mystery where the Medicaid money went.
California is the poster child for this mismanagement. According to the California Department of Finance, the state will spend over $8.4 billion this year alone on Medicaid benefits for illegal aliens—more than $5 billion above initial estimates. And that’s just for healthcare. Now California wants federal taxpayers to cover the tab for their overspending.
In New York, Governor Kathy Hochul allocated $2.4 billion in the 2025–26 state budget for “migrant services”—including legal aid, medical care, and housing for asylum seekers and other noncitizens. Meanwhile, New York City is expanding a controversial program that distributes prepaid debit cards loaded with cash to migrant families staying in taxpayer-funded hotels. These aren’t isolated cases—they’re symptoms of a system addicted to rewarding illegal entry.
Other states are just as reckless. In Illinois, Gov. JB Pritzker’s administration vastly underestimated the cost of a pair of health insurance programs for immigrants who are not citizens that has ended up costing the state $1.6 billion since the initiative began in 2020, according to an audit report . It covers “undocumented” seniors and adults aged 42–64.
Just days ago, Massachusetts Governor Maura Healey approved a $5 million to provide immigrants at risk of deportation with legal counsel.
Oregon offers full reproductive care—including taxpayer-funded abortions—to illegal immigrants. The state’s website openly blames “structural racism and xenophobia” for why undocumented immigrants lack access to comprehensive care. Their stated goal? “Cover all people.”
Washington State diverted $340 million in federal COVID relief funds to illegal immigrants through $1,000 checks. That’s just a sliver of the broader picture. From coast to coast, Democrats are pouring billions into benefits for illegal immigrants—while screaming that Trump’s Medicaid cuts will leave Americans to die.
Cue the outrage.
Rep. Frank Pallone, D-N.J., joined Sen. Ron Wyden, D-Ore., and Rep. Richard Neal, D-Mass., to decry the bill, claiming it “creates barriers and mazes” that will kill tens of thousands. Rep. Pramila Jayapal, D-Wash. said: “This is a cruel, horrific betrayal that will leave Americans poorer and sicker. Thanks to Trump, Republicans, and this bill, people will die.” House Minority Leader Hakeem Jeffries called it “wrong,” “dangerous,” and “cruel.” Senate Majority Leader Chuck Schumer threw a hissy fit over the bill. He said, “This is not a ‘big, beautiful bill’ at all. That’s why I moved down the floor to strike the title. It is now called ‘the act.’ That’s what it’s called. But it is really the ‘big ugly betrayal.’”
But these hysterical talking points don’t hold up.
The OBBB doesn’t cut coverage—it shifts financial responsibility back to the states. If Democrat-led states weren’t burning billions on illegal immigrants, they’d have more than enough to cover their Medicaid rolls. Their outrage isn’t about protecting the poor—it’s about protecting the federal handouts they’ve come to depend on.
Democrats aren’t furious that people might lose healthcare. They’re furious that Washington won’t bail them out this time.
The real betrayal is the prioritization of illegal immigrants over American citizens. While American families struggle to afford care, blue states pour taxpayer dollars into services for those here illegally. Trump’s One, Big, Beautiful Bill finally draws a line: either pay for what you demand—or live within your means.
Democrats chose the open-borders lobby over the American people. Voters should remember that.
Sources
- The Fiscal Burden of Illegal Immigration on United States Taxpayers https://www.fairus.org/issue/publications-resources/fiscal-burden-illegal-immigration-united-states-taxpayers-2023
- Reuters (April 30, 2025) – Confirms the bill scales back federal Medicaid funding for expansion states, caps provider tax schemes, and shifts more cost to states, supporting my points about capping the federal match, curbing spending, and making states fund any Medicaid expansion. reuters.com/business/healthcare-pharmaceuticals/republicans-weigh-cuts-medicaid-that-could-dramatically-affect-millions-2025-04-30
- Reuters (July 3, 2025) – Details key provisions in the final bill, including mandatory work requirements, eligibility checks, cost-sharing for expansion enrollees, and a new inflation-based cap on provider tax revenue, reinforcing that states must bear more responsibility. reuters.com/business/finance/key-healthcare-provisions-trumps-tax-bill-2025-07-03
- California Medicaid Spending: https://budget.house.gov/press-release/california-to-spend-84-billion-this-year-on-health-care-for-illegal-aliens?
- During the next two years, the New York state budget allocates $2.4 billion for support for migrants. https://www.politifact.com/article/2024/may/30/state-taxpayers-offer-flexible-funding-for-migrant/
- NYC to spend millions on new round of pre-paid debit cards for migrants https://nypost.com/2024/07/03/us-news/nyc-to-spend-millions-on-new-round-of-pre-paid-debit-cards-for-migrants/
- Illinois Immigrant Health Audit: https://www.yahoo.com/news/audit-finds-thousands-were-improperly-234600903.html
- Massachusetts Illegal Immigrant Legal Defense Fund: https://miracoalition.org/news/protect-our-immigrant-communities-campaign-celebrates-expanded-legal-aid-for-immigrants/
- Oregon Reproductive Health Equity Act: https://www.oregon.gov/oha/ph/healthypeoplefamilies/reproductivesexualhealth/pages/reproductive-health-equity-act.aspx
- Washington State diverted $340 million in federal COVID relief funds to illegal immigrants. https://nypost.com/2024/02/03/news/washington-state-diverted-340m-in-federal-covid-funds-to-migrants/
- Rep. Frank Pallone Criticism: https://pallone.house.gov/media/press-releases/pallone-neal-wyden-release-latest-cbo-estimates-showing-16-million-people-will
- Rep. Pramila Jayapal Criticism: https://www.yahoo.com/news/wa-members-congress-react-passage-235941737.html
- House Minority Leader Hakeem Jeffries Criticism: https://www.nbcnews.com/politics/congress/house-minority-leader-hakeem-jeffries-blasts-republicans-trump-agenda-rcna216731
- Senate Majority Leader Chuck Schumer Comments: https://redstate.com/bobhoge/2025/07/01/schumer-changes-name-of-the-one-big-beautiful-bill-in-last-minute-snit-fit-n2191133