President Donald Trump’s administration is threatening to crack down on Utah — and just over a dozen other states — if it continues to provide health insurance for immigrant children without permanent legal status.
The Centers for Medicare & Medicaid Services will begin “ramping up financial oversight” of states that give federally subsidized coverage to immigrants, it said in a letter to states Tuesday. As many as 2,000 children living in Utah would lose access to medical treatment if the state moves to abolish its program.
The warning comes as Congress weighs a separate measure to penalize states with such policies as part of the “One Big Beautiful Bill,” which, as currently drafted, would slash the federal contribution to medical coverage for some low-income residents in Utah and places with similar programs.
“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” Mehmet Oz, the doctor and TV host who was appointed by Trump to oversee Medicaid and Medicare, said in a statement accompanying the letter. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice — [Centers for Medicare & Medicaid Services] will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”
Utah lawmakers have already signaled they may consider a special session to repeal coverage, but the official with the most power to call the Legislature into one, Gov. Spencer Cox, did not respond to a request for comment from The Salt Lake Tribune on the letter.
Legislative leaders may also convene a special session in the case of a persistent financial crisis, war, natural disaster or other emergency. A spokesperson said Wednesday they are still reviewing the letter and working to better understand its implications.
Citing an executive order Trump issued in February titled “Ending Taxpayer Subsidization of Open Borders,” the CMS letter accused states that offer health care to noncitizen kids of “improper spending” and having “pushed the boundaries” of federal law. It pledged to audit and increase overall oversight of states that extend that coverage.
According to numbers published by Utah’s Department of Health and Human Services earlier this month, 1,312 children are currently provided health care under the program. The state has the capacity to offer coverage to as many as 2,000 immigrant kids.
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This article is published through the Utah News Collaborative, a partnership of news organizations in Utah that aims to inform readers across the state.