Nearly $200M in Direct Federal Grants Has Been Aimed at Expanding Programs to Serve Illegal Immigrants

Illegal immigrants have benefitted from at least $197 million in direct federal healthcare-related grants since fiscal year 2021, according to new research from Open the Books. This figure does not include indirect spending on illegal immigrants via Medicaid, which was estimated by the Congressional Budget Office to be around $27 billion from FY 2017-2023, nor does it account for education spending that benefits illegal immigrants and their children, which amounts to an estimated $70 billion annually.

While some elected officials insist illegal immigrants cannot access federal spending, the nearly $200 million identified by Open the Books covers grants for healthcare outreach and provisioning, along with supposedly scientific studies aimed at expanding federal and state programs to include illegal immigrants. Such spending has been reduced considerably since Donald Trump took office but Open the Books researchers still identified $13 million in relevant spending since February 2025.

The funds identified are unlikely to reflect the full universe of federal spending on illegal immigrants; these findings merely reflect grants and programs that explicitly use terms like “undocumented” in their descriptions.

Amount of funding in grants targeting “undocumented” populations in the United States, by fiscal year.

Health-related spending is principally directed towards programs serving the neediest members of society, such as the homeless, drug-addicted, or otherwise medically fragile. The expansion of programs to include illegal immigrants both encourages illegal migration into the United States and directs spending away from high-poverty Americans.

“Scientific” Projects

$18 million in federal spending since fiscal year 2021 was directed towards health-related research projects involving illegal immigrants. In general, the stated goals of these projects are to expand access to healthcare or other taxpayer-funded programs in the name of health “equity.” Some examples include:

• $4.3 million went to Stanford from the National Institutes of Health for “income interventions to address the fundamental causes of cancer inequities.” The program will study how universal basic income given by the state of California, a 2,000-person pilot program including illegal immigrants, can impact cancer risk. Results “will lay the foundation for transformative approaches to address cancer prevention and control programs in the face of severe economic and social disadvantage through capacity building and sustainable partnerships with policymakers, state and local agencies and community partners.”

• $2.4 million went to University of California, Los Angeles, from the NIH to study “the use of reproductive healthcare among Asian immigrant women,” including “undocumented Asians, who experience greater barriers to access than their documented peers.” The short-term goal of the research is to identify sexual and reproductive health outreach interventions, which will help “achieve thelong-term goal to improve the sexual and reproductive health equity of immigrants, families, and communities.”

• $1 million for a University of Miami from the NIH for a study on “culturally relevant” interventions for drunk driving. It acknowledges previous research showing that compared to permanent residents:

  • “Undocumented immigrants were less likely to understand DWI [driving while intoxicated] laws, more likely to binge drink, and less likely to perceive the associated risks. Despite such elevated risk factors, undocumented immigrants were less likely to be involved in DWI events than permanent residents, in part because of their desire to stay undetected by law officers, but largely because of their limited access to cars.”

  • The study aimed to acquire understanding of the various factors that influence drinking and driving in this population, and “culturally relevant intervention strategies to prevent” intoxicated driving.

• $424,752 University of California, Irvine, from the NIH to study “access to medical care and health care utilization among low-income immigrants” with the ultimate goal of helping “support the development of local and state-level policies that expand access to care for undocumented residents as well as help policy makers, clinicians, and researchers anticipate outcomes after these policies are implemented.”

• $18,678 to University of Southern California from the NIH to study “disparities in end-of-life care in undocumented Hispanic immigrants,” who face “numerous barriers to obtaining healthcare services.” The study aims to “inform the development of targeted interventions that aim to mitigate the identified barriers and promote quality of life for undocumented immigrants at end of life.”

• $47,694 to the University of Miami to support a project to connect illegal immigrants to employment that sought to prevent them from engaging in risky behaviors that could lead to an HIV infection. The funds supported a fellowship that studies how a “Work 2 Prevent” program can “address the structural barriers for LMSM [Latino Men who have Sex with Men] with recent immigration histories who may be monolingual Spanish-speaking, or undocumented.” The grant states that such a study is “urgently needed” to achieve “health equity.”

Direct Programmatic Spending

Most of the identified spending on illegal immigrants went to programs providing services directly to the public (as opposed to scientific research). Of the $185 million in total programmatic spending, $182 million came from the Department of Health and Human Services (HHS). The remaining $2.5 million came from the Corporation for National and Community Service, which runs programs like AmeriCorps.

The Health Resources and Services Administration (HRSA), a sub-agency of The Department of Health & Human Services, spent at least $75.6 million on grants serving illegal immigrants. HRSA’s mission is to “provide health care to people who are geographically isolated and economically or medically vulnerable.”

The bulk of HRSA funding serving illegal immigrants flows through the Ryan White HIV/AIDS Bureau, which provides medical care for low-income people with HIV. Ryan White was a young man who died of AIDS after a transfusion with infected blood in 1990. Grants include:

• $833,594 to the Northern Nevada HIV Outpatient Program, which provides services like “targeted high-risk HIC testing, HIC medical care, primary care, medical case management, treatment adherence counseling, specialty care referrals, pharmacy services, non-medical case management, behavioral health counseling, retention in care activities, transportation assistance, and housing rental assistance.” In the grant application, the nonprofit says 7% of the people they serve are undocumented.

• $655,154 to the Northern Nevada HIV Outpatient program, which provides services like “adult and pediatric primary care; chronic disease management; radiology/ultrasound; medical/non-medical case management; individual, group, and family behavioral health treatment; psychiatry; medication assisted treatment for opioid and/or alcohol dependence; intensive-outpatient program for substance use and cooccurring mental health disorder” along with “services that reduce access barriers and increase health outcomes, such as rent and utility payment assistance; insurance enrollment and benefits counseling; transportation assistance; and a medical-legal partnership program.” The funded grant states that 5% of its patients are undocumented.

  • Some grantees note that they need more funding because illegal immigrants are not always represented in U.S. census counts determining Congressional appropriations. For one $180,00 Ryan White grant, Lifespring Health Systems said their “southern Indiana community is also home to a large refugee and immigrant population from various countries, with data being underreported as many individuals are undocumented and do not report this to the us census bureau. This limits funding that is provided to the community even though need is great.”

$31 million went to programs treating substance abuse via the HHS Substance Abuse and Mental Health Services Administration. A couple of examples of such spending include:

• $4 million to Communities Wellness Centers USA for an expansion project that “will increase access to behavioral health and substance use disorder services, as part of their comprehensive integrated primary care model, to the minority low-income black/African American, Cambodian, and Latinx refugee and undocumented populations of Southern Los Angeles County.”

  • Some of the services being offered will include “individual, group, and family therapy, increased screenings for behavioral health services, patient-centered treatment plans, crisis care, Substance Use Disorder services including Medication Assisted Treatment, Assertive Community Treatment (ACT), HIV and viral hepatitis screenings, psychiatric rehabilitation services, and wrap-around intensive case management.” The grant states that 2,650 people will be treated with the funding.

• $2.6 million to Via Care MAT and Recovery, to provide “medically-assisted treatment with buprenorphine [a drug that reverses the effects of opioid overdose] and comprehensive wraparound recovery support services” to 370 people. The program is targeted towards “low-income, primarily Latinx adults diagnosed with an opioid use disorder” in East Los Angeles, including those who are “undocumented.”

  • Recovery support services for participants include “medical management, coordination of follow-up care, telehealth monitoring, relapse prevention, overdose education and support for self-management” and will coordinate “prescribing providers, a clinical pharmacist, psychiatric nurse practitioner, licensed clinical social worker, and two peer recovery support specialists who will provide psychosocial case management.”

While federal dollars are not supposed to support illegal immigrants accessing critical social services, during the Biden administration the Centers for Medicare and Medicaid Services spent $2.8 million in separate grants to California and Virginia to help the states enroll illegal immigrants, among others, to Medicaid-funded state healthcare programs. The California grant, for example, explicitly states it includes “those from Mixtec, undocumented and migrant populations who are eligible for coverage under California’s Medicaid expansion.”

Similarly, an Americorps program spent $2.5 million to “assist with outreach across the state of Colorado to individuals - largely individuals who are undocumented - who will be newly eligible for state subsidized health insurance coverage through Colorado’s Health Insurance Affordability Enterprise.” The grant states that after one year, the program aims to connect 300 people newly eligible for state subsidized health insurance plans to assisters who will help them enroll in health insurance.

Federal Subsidies to California’s Sanctuary Status

Perhaps unsurprisingly, the state of California has reaped by far the most federal tax dollars related to illegal immigrant healthcare, at $65.5 million. Florida comes in a distant second with $26 million, followed by D.C. at $22 million.

As demonstrated in the earlier examples in this report, California is subsidizing its generous healthcare expansion policies through programs and research also supported by federal tax dollars.

Earmarks

Five projects directly supporting illegal immigrant healthcare identified for this report are Congressionally directed earmarks, meaning members of Congress singled these projects out specifically for funding. All such spending came from HRSA funds.

• $1.5 million total award to NYU Langone Hospitals, earmarked by Democratic New York senators Chuck Schumer and Kirsten Gillibrand, for a new cancer center in New York City, serving a high-poverty area of 152,700 residents. That grant states “almost 50 percent of the population is foreign–born with many being undocumented.”

• $441,000 total award to Volunteers in Medicine Berkshires, earmarked by Democratic Massachusetts senators Ed Markey and Elizabeth Warren, to provide services like “primary and preventive medical care, women’s health, orthopedics, gastroenterology, cardiology, infectious disease, full restorative dentistry, behavioral health, optometry, diabetic and nutritional counseling, and non-opioid pain management using acupuncture, therapeutic massage, and mindfulness training” to a “predominantly undocumented immigrant population.”

• $1 million total award to Clinica Monsenor Oscar Romero, earmarked by California representative Jimmy Gomez to “increase access to primary care services including medical, dental, and behavioral health and substance use disorder services, as part of their comprehensive integrated primary care model, to the minority low-income Latino homeless and undocumented populations of Los Angeles.”

• $592,000 total award to University of California, Los Angeles, earmarked by California representative Ted Lieu, for a UCLA mobile healthcare program targeting people “experiencing homelessness,” included illegal immigrants.

• $175,000 total award to Project Access Now, earmarked by Oregon senators Ron Wyden and Jeff Merkley, to serve clientele who are “largely low-income, from immigrant populations, non-English-speaking, and/or undocumented.”

Conclusion

The $197 million our investigators identified in direct taxpayer support to illegal immigrants is dwarfed by both indirect support to illegal immigrants via programs like Medicaid and education systems and this year’s massive expansion of the Department of Homeland Security. According to the Federation for American Immigration Reform, illegal immigration costs taxpayers $150.7 billion per year the federal state and local level. Meanwhile, this year’s budget reconciliation bill directs $45 billion to the Immigration and Customs Enforcement agency’s detention budget and nearly $30 billion to ICE’s enforcement and deportation operations over the next four years. The bill directs an additional $46.5 billion to border security infrastructure.

The Trump administration has sought to reduce direct and indirect funding for illegal immigrants but $13.3 million was spent on grants related to illegal immigrants and healthcare since February 2025. Meanwhile, the surge in funding for border security has led to a significant decrease in illegal border crossings. The Trump administration reported 26,197 total border encounters nationwide in August, which was 93% below the peak of the Biden administration’s 370,883. However, the administration’s massive expansion of the administrative state’s immigration enforcement offices has not led to a significant increase in the rate of deportations. The administration argues it is on pace to deport a record 600,000 illegal immigrants by the end of the year but has so far deported fewer illegal immigrants (400,000) than President Obama did per year from 2012-2014.

If the administration’s deportation estimate of 600,000 holds, the cost per additional deportation compared to Obama will be $375,000 per deportation. This figure assumes the cost of additional immigration enforcement is $75 billion, which is then divided by 200,000 (the number of additional deportations under Trump compared to Obama). By comparison, the median cost of a home in the U.S. is $416,900.

As more data becomes available, Open the Books will carefully study the delta between peak Obama deportations and peak Trump deportations and help taxpayers understand the value of their support for increased border security and enforcement.

Regardless, taxpayers have a right to know where their money is going so they can hold their elected officials accountable. The data and evidence clearly show direct and indirect funding for illegal immigrants. At the same time, immigration enforcement is extremely costly.