Florida Spends $660M on Healthcare for Undocumented Immigrants Amid New Hospital Rules

Florida's healthcare system shelled out nearly $660 million in 2024 to cover costs associated with undocumented immigrants, according to new data from the Florida Agency for Health Care Administration (AHCA). The findings were part of the AHCA's Hospital Patient Immigration Status Dashboard, which tracks hospital admissions and emergency room visits categorized by immigration status.

The report reveals that 67,700 emergency room visits by undocumented individuals resulted in approximately $76.6 million in Medicaid payments for emergency care. The total costs for treating undocumented immigrants reached the staggering $660 million mark statewide. Miami-Dade County alone accounted for nearly half of that sum, spending an eye-watering $282 million.

Neighboring Broward County spent $77 million, Hillsborough County (home to Tampa) $64 million, Orange County (Orlando) $38 million, and Duval County (Jacksonville) $34 million. Some rural counties in the Big Bend region, lacking hospitals, reported no associated costs.

AHCA Deputy Secretary Kim Smoak commented, "The data confirms that the financial burden of illegal immigration continues to strain Florida’s healthcare system. We will continue working to ensure that hospitals and healthcare providers deliver quality services to U.S. citizens."

In line with Governor Ron DeSantis' immigration crackdown, a 2024 state law required hospitals accepting Medicaid to ask patients about their immigration status. While patients are not obligated to answer, the law has reportedly led to a 54% decline in Medicaid billings to state programs covering undocumented immigrants' medical expenses. However, the move hasn’t been without challenges—at Tampa General Hospital-Spring Hill, nearly two-thirds of ER patients declined to answer the citizenship question during the first quarter of 2024. Flagler Hospital near St. Augustine saw an even higher rate, with 96% of its 36,000 ER patients refusing to answer.

State Rep. Randy Fine, a co-sponsor of the legislation mandating hospitals to collect immigration data, expressed frustration with the costs, labeling the $500 million spent last year as “half a billion dollars stolen from real Floridians.” His remarks reflect the ongoing debate over balancing care for undocumented immigrants with the financial strain on the state.

Meanwhile, in a federal push to address undocumented immigration, former President Donald Trump removed hospitals from the list of locations considered off-limits for Immigration and Customs Enforcement (ICE) activity. This change could further influence how hospitals and states handle such cases moving forward.