DHS cites California ambulance cost surge
The Department of Homeland Security pointed to new California data showing Medicaid-funded ambulance reimbursement rising from $339 per transport in 2022 to $1,168 in 2024, with state requests to CMS to increase rates to $1,597 in 2025 and $1,637 in 2026. DHS Assistant Secretary Tricia McLaughlin said DHS and CMS are exploring an initiative to ensure undocumented immigrants are not receiving Medicaid benefits, while California has already moved to freeze new Medi-Cal enrollment for undocumented adults in 2026 and to charge a $30 monthly premium to those already enrolled starting July 2027.
📌 Key Facts
- California DHCS data: ambulance reimbursements rose from $339 (2022) to $1,168 (2024).
- State has submitted two CMS requests to raise rates to $1,597 (2025) and $1,637 (2026)—about a 382% increase since 2022.
- DHS says it is working with CMS on an initiative regarding Medicaid eligibility for undocumented immigrants; California plans a 2026 Medi-Cal enrollment freeze for undocumented adults and a $30 premium starting July 2027.
📊 Relevant Data
California's private ambulance providers continue to receive $339 per transport under Medi-Cal, while public providers were paid $1,065 in 2023 and $1,168 in 2024.
State Funding Gimmicks Drive Unequal Ambulance Payments in Medi-Cal — Paragon Institute
The CMS increased the Medicaid reimbursement rate for government ambulance services in California by more than $800 for calendar year 2023, but only for government providers.
Boosted Federal Matching Funds Help Localities Ratchet Up Spending — Forbes
Nearly 1.7 million undocumented immigrants are currently enrolled in Medi-Cal in California.
Medi-Cal Coverage for Undocumented Immigrants in California — Institute for Health Policy and Leadership, Loma Linda University
California is estimated to spend $8.4 billion to cover undocumented immigrants in Medi-Cal in the 2024-2025 fiscal year.
Medicaid shortfall forces California to borrow $3.44B — Politico
The undocumented immigrant population in California is estimated at 1.8 million, representing about 4.6% of the state's population, with most originating from Latin America.
Immigrants in California — Public Policy Institute of California
Undocumented immigrants in California have lower levels of health care utilization and spending relative to U.S.-born residents.
Health Care and California’s Undocumented Immigrants — Public Policy Institute of California