More GOP States Order Medicaid Agencies To Flag Suspected Undocumented Enrollees

Republican state officials in multiple states have ordered Medicaid agencies to flag suspected undocumented enrollees and report them to federal immigration authorities, a change critics say is already chilling access and could lead to deportation.^[1]

The push follows former President Donald Trump's public demand that states turn over Medicaid data to aid deportations.^[1] State health officials say they are being directed to identify recipients whose immigration status they deem "unsatisfactory" and pass that information to federal authorities.

In late April 2026, North Carolina enacted a law requiring its health department to report Medicaid recipients without "satisfactory" immigration status to the Department of Homeland Security, effective October 2026. North Carolina folded the reporting mandate into legislation restoring $319 million in Medicaid funds that had been cut when a state budget failed last year. At least four other GOP-led states — Indiana, Louisiana, Montana and Wyoming — have already passed similar reporting laws, and lawmakers in Oklahoma and Tennessee are weighing related measures.^[1]

All seven measures identified go beyond federal rules, which require states to provide Medicaid recipient information only when enforcement agencies specifically request it. Advocates in Louisiana and North Carolina say the laws are already discouraging some mixed-status families from applying for Medicaid for their U.S.-citizen children, raising concerns about health access and child welfare.^[1]

1. CBS