Immigration and Customs Enforcement (ICE) is helping alleviate pressure on America’s emergency rooms because illegal aliens believe they might be arrested and deported if they use the emergency services.
Illegal aliens are well-known to abuse such emergency services for non-emergencies, not pay, and leave the American people to pay for it. But the Los Angeles County Department of Health Services (LACDHS) confirmed to The Federalist that recent ICE activity is stopping many illegals from seeking emergency services as well as scheduled appointments.
“We can confirm that our health system has in fact seen a decline in both Emergency room visits and in rates of patients showing up to scheduled health appointments,” LACDHS told The Federalist. The department also claimed that “the fear caused by the aggressive approach of the ICE raids has left many in the LA County communities fearing for their safety. Regardless of immigration status, the patients we serve are expressing fear and anxiety.”
LACDHS operates the Los Angeles General Medical Center, which has notoriously long wait times and is “known to have a lot of illegal immigrants,” Dr. Jared Ross, an emergency room physician in Missouri who worked in the LA General emergency room during medical school, told The Federalist. Ross described exorbitant wait times while working there, sometimes 10-plus hours.
With LA General seeing a drop in illegal alien patients, even on top of the state-provided and taxpayer-funded benefits given to them, it is hard to imagine hospitals across the country have not experienced same phenomenon.
“We have a massive problem with ER overcrowding in the country,” Ross added, stating that the issue is extremely complicated and that there are numerous ways that illegals have abused the American health care system.
Federal Focus
Aside from ICE enforcement, the Trump administration has focused on making sure illegals are not leeching off American taxpayer resources in other areas. For example, the “Big Beautiful Bill” stops about 1.4 million illegal aliens from receiving certain benefits from Medicaid.
Through an executive order, President Donald Trump directed federal agencies to “identify all federally funded programs currently providing financial benefits to illegal aliens and take corrective action,” ensure “that federal funds to states and localities will not be used to support ‘sanctuary’ policies or assist illegal immigration,” and improve “eligibility verification to prevent benefits from going to individuals unlawfully present in the United States.”
As The Federalist reported, the Departments of Health and Human Services, Education, Labor, Justice, and Agriculture have also taken steps to remove illegal alien eligibility from various programs.
“President Trump’s agenda to deport criminal illegal aliens will improve Americans’ quality of life across the board. American resources, funded by American taxpayers, will no longer be stretched thin and abused by illegals,” White House spokeswoman Abigail Jackson told The Federalist. “Civic services will be directed solely to Americans – the way it should be – and not exploited by illegals.”
Who Takes The Brunt Of The Burden?
When a patient enters an emergency room, they are categorized on the Emergency Severity Index (ESI), a scale of one (immediate care / life threatening) to five (least urgent). That allows doctors to determine how to prioritize care based on need.
Ross said that someone ranked a five “probably shouldn’t be in the ER, they should probably be in an urgent care setting.” Many fours are the same, he said.
However, he said that the vast majority of patients are twos and threes — people who do belong in the emergency room, but may experience some of the extraordinarily long wait times that many ERs see across the country.
The real people suffering from 6-12-plus hour wait times are not the people who come in with obvious trauma (think a compound fracture broken through the skin or a gunshot wound), but rather those who rightfully come into an emergency room but whose medical issue is not immediately life-threatening. Doctors in emergency rooms are required to respond to each and every patient who comes in and need to make decisions from less obvious symptoms. For example, if someone comes in with a stomach ache, it could be the flu or appendicitis, which can turn life-threatening.
“The vast majority of patients are twos or threes — the vast majority are probably threes. And while we do a good job trying to really suss out these people who are sick and who have a life-threatening emergency, some of those patients haven’t quite declared themselves when they’re triaged,” Ross said. “They might get triaged as a three and then spend six-to-12-plus hours in an urban setting, in an ER, waiting for a room. And those are people that can really decompensate, and those are the patients that are really suffering from ER overcrowding the most.”
Illegal Aliens Strain American Health Care
Even before illegal aliens come into the picture, the United States has what could likely be referred to as a crisis in wait times and hospital bed shortages across the country.
According to the Wall Street Journal, the United States has fewer than three hospital beds for every 1,000 residents. Comparatively, the European Union has over five, and Japan has nearly 13. The percent of hospital beds occupied on a given day has also grown 11 points since 2019, to 75 percent (85 percent is a threshold at which hospitals can no longer function properly due to overcrowding).
Average emergency room wait times in many parts of the country are also absurd.
In Washington, D.C., Georgetown University Hospital posts a 6.8-hour average. Medstar Washington Hospital Center is at 6.1 hours, and Medstar Georgetown University hospital clocks in at 5.8 hours.
Maryland, which reportedly has the longest wait times in the country, has many hospitals in the above-five-hour range. New York State has hospitals in the 4-5 hour range, on average.
The burden illegal aliens put on the American health care system is well-known, but, as Julie Kirchner, America First Policy Institute (AFPI) senior fellow for Homeland Security and Immigration, told The Federalist, many supporters of illegal immigration work tirelessly to ensure no data can be collected on just how big that burden is.
However, the data that does exist paints a stark picture.
According to a 2023 report from the House Homeland Security Committee, the 2021 “total Medicaid costs for ‘emergency services for undocumented aliens’… exceeded $7 billion, while in FY22, these costs were more than $5.4 billion.”
A 2024 report from the House Judiciary Committee said that the use of emergency medical services by illegal aliens likely costs around $7 billion every year.
Even before the Biden administration allowed millions of illegals into the country during his tenure, Forbes reported that American taxpayers were funding $18.5 billion in health care for illegal aliens through various means, including Medicaid, Obamacare, state and local programs, and “cost-shifting,” meaning those with medical insurance are paying more to cover uncompensated care losses at hospitals.
According to a report out of Texas, hospitals spent $121 million in the month of November 2024 alone, covering for over 31,000 visits from illegals. From December through February, illegals visited Texas hospitals nearly 80,000 times, costing $329 million.
Florida reportedly spent $660 million statewide on illegal immigrants in 2024.
But Texas and Florida are both states that decided to start systematically tracking illegal aliens’ burden on their health systems.
Democrat-run states like California, Washington, Oregon, Colorado, and Illinois have actually expanded the cost burden on American citizens by allowing illegals to access health care facilities.
In California, the average wait time is four hours and 34 minutes, which is above the two-hour-and-43-minute national average. Gov. Gavin Newsom, D-Calif., in 2023 signed a law allowing illegals to jump on the state’s version of Medicaid, Medi-Cal.
Less than two years later, Newsom proposed to freeze Medi-Cal enrollment for illegal aliens, but only beginning in 2026 and the 1.6 million illegals already enrolled would remain insured. While the move would reportedly save the state over $5 billion, it is unlikely to succeed because the state’s Democrat Senate Majority Leader, Lena Gonzalez, is vehemently opposed to it.
Even if it were to end, that would only be after illegals already cost California $9.5 billion on health care in the 2024-25 budget year alone.
As the Center Square reported, “While homeless and undocumented individuals qualify for Medi-Cal, many are not enrolled and use ERs as their only form of medical care.”
As White House Deputy Chief of Staff Stephen Miller, a native Californian, has said, “At every turn illegal aliens have always been treated better than Americans.”
“Do you have any idea how many resources will be opened up for Americans when the illegals are gone? No more waiting in line at an emergency room, no more massive traffic in Los Angeles,” he continued. “Your health insurance premiums go down, your public school classroom size will shrink dramatically. They have more time to educate every student. You won’t have to compete for public benefits.”
Similar stories to California have happened in the other states as well.
Denver hospitals actually wanted a federal bailout after 8,000 illegals posted about 20,000 visits to Denver Health in 2023, with the CEO stating the illegals are putting a huge burden on their operation.
Illinois had a budget shortfall, and has thought about ending its health program for some illegal immigrants as well.
EMTALA Reform?
For now, separately from the alleviation from ICE, illegals will still be able to get emergency room treatment and leave Americans with the bill unless federal law is reformed — something Ross told The Federalist will be a difficult process.
Federal law under the Emergency Medical Treatment and Active Labor Act (EMTALA) requires that emergency rooms treat patients regardless of their immigration status or ability to pay.
“I would think we all agree we’re a compassionate society, but for the past six months, illegal aliens have been given ample opportunity to return home by getting paid to voluntarily depart and then come back legally,” Cooper Smith, AFPI director of communications, told The Federalist. “While it is under federal law they can use emergency rooms they’ve been given … at what point does our compassion intersect with reality?”
Kirchner said the only long-term solution is to try to reduce the illegal alien population overall, and “at that point, some of that will take care of itself.”