The Trump administration is launching an investigation into Colorado Medicaid spending on undocumented immigrants, an extensive data request from federal officials reveals.\u00a0<\/p>\n
The 11 pages of requested information, which The Colorado Sun obtained through the state open records act, asks about Colorado spending and policies, and seeks personal information about Medicaid claims during the past three months, including patients\u2019 immigration status.\u00a0<\/p>\n
In an email accompanying the data request, the federal Centers for Medicare and Medicaid Services said it intends to review claims that Colorado submitted for federal matching funds to pay for people\u2019s medical care. Federal law generally prohibits states from using federal money to pay for nonemergency care for people without \u201csatisfactory immigration status.\u201d Many adult immigrants with legal status must complete a \u201cfive-year waiting period\u201d during which they are not eligible for nonemergency services.\u00a0<\/p>\n
\u201cThe Centers for Medicare & Medicaid Services is committed to the fiscal integrity of the Medicaid program\u201d and wants to ensure that federal money is used in accordance with the law, states the June 6 email from Dorothy Ferguson, a financial operations division director at the Centers for Medicare and Medicaid Services.\u00a0<\/p>\n
The Colorado Department of Health Care Policy and Financing, which operates the Medicaid program for people who have low incomes or disabilities, has not yet responded to the data request. State officials are \u201ccurrently evaluating the requests,\u201d department spokesman Marc Williams said in an emailed statement Tuesday. \u201cWe believe that other states have received similar requests.\u201d<\/p>\n
The state Medicaid program \u201chas always been required to regularly share detailed information in order to claim federal matching funds\u201d but this request is \u201clengthy and more detailed,\u201d Williams said. Federal officials gave a July 30 deadline.\u00a0<\/p>\n
The request comes after Colorado, when former President Joe Biden was in office, expanded health coverage to immigrants<\/a> living in the state, including those who do not have legal immigration status. Colorado did this through two programs, one of which is called Cover All Coloradans.\u00a0<\/p>\n The program began this year and provides Medicaid coverage for children and pregnant and post-partum women no matter their immigration status. It has enrolled more than 21,000 people, including more than 16,000 children ages 0-18, who would qualify for Medicaid if not for their immigration status.<\/p>\n The program for children is funded through state dollars, but Colorado does receive a federal match for coverage for pregnant women, which is an exception under federal law.<\/p>\n Through a separate, longstanding program known as Emergency Medicaid, Colorado also receives federal dollars to pay for emergency health care for adults who are not citizens. This type of program exists in every state in the country<\/a>, with some variation.<\/p>\n Colorado\u2019s second program expanding health coverage for undocumented immigrants is called OmniSalud, and it is separate from Medicaid. The program provides a secure online marketplace for people to purchase private health insurance plans, and it provides state-funded subsidies to many to help pay for that coverage.<\/p>\n Nearly 14,000 people signed up for insurance plans this year<\/a> through the program, the large majority of whom received subsidy help.<\/p>\n OmniSalud does not share information with the federal government, and a spokesperson for the program said last week that it has not received any requests to do so.<\/p>\n Three Republican members of Colorado\u2019s Congressional delegation last week sent a letter<\/a> to Gov. Jared Polis urging him to end both OmniSalud and Cover All Coloradans, saying the programs could put Colorado at risk of losing some federal funding under the massive federal tax and spending bill currently being debated.<\/p>\n Colorado provided more than 36,000 noncitizens with emergency care last month<\/strong><\/p>\n The federal request focuses mainly on emergency care for adults who are undocumented or who have not had legal status for at least five years. Colorado Medicaid paid for emergency medical care for 36,834 noncitizens in May, according to data provided by the department Tuesday.\u00a0<\/p>\n Federal funding for emergency health care for undocumented immigrants is allowed under federal law because without it, hospitals would have to absorb the cost of care since they are not allowed to turn anyone away during an emergency.<\/p>\n The request seeks data that federal investigators can use to \u201creplicate the process\u201d the state used to determine how Colorado separated emergency claims from nonemergency claims.\u00a0<\/p>\n It asks for spreadsheets listing adults with \u201cunsatisfactory immigration status,\u201d including coverage eligibility data, benefits and funding. It also requests Colorado\u2019s Medicaid codes for emergency medical services and a \u201cdescription of how Colorado determines an emergent condition that would be eligible for federal match.\u201d<\/p>\n The spreadsheets must include the person\u2019s immigration status, Medicaid identification number, birth date, and the reason they were eligible for Medicaid \u2014 such as a disability, pregnancy, income status, the request says. Federal officials also asked for copies of all of Colorado\u2019s policies, laws, audits and procedures to ensure that federal money is not spent on any nonemergency care for adults who do not have legal status.\u00a0<\/p>\n The data request does not seek information about beneficiaries who are younger than 19.\u00a0<\/p>\n Concern that federal health officials will share the data with ICE<\/strong><\/p>\n The request comes from federal Medicare and Medicaid Services, which is responsible for investigating fraud, and not from the Department of Homeland Security, which includes U.S. Immigration and Customs Enforcement.\u00a0<\/p>\n It\u2019s unclear, however, whether the federal health agency would share the information it might receive from the request with other federal agencies. The Associated Press reported<\/a> this month after obtaining an internal memo that federal Medicare and Medicaid officials shared Medicaid data from California, Washington, Illinois and Washington, D.C., after being ordered to do so by the Department of Homeland Security. Centers for Medicare and Medicaid Services officials were given less than an hour to comply with the directive, the AP reported.<\/p>\n Immigrant and health advocacy groups have called on Colorado officials not to comply with the data request.\u00a0<\/p>\n \u201cThis data request is not about health or program integrity \u2014 it\u2019s about authoritarian surveillance,\u201d said Annie Mart\u00ednez, litigation director of the Colorado Center on Law and Policy. \u201cPublic health data must never be used to criminalize sickness, poverty or immigration status.\u201d<\/p>\n The request targeting Colorado Medicaid spending on immigrants came after the Colorado Department of Labor and Employment received a subpoena from ICE ordering the state agency to turn over personal information about people who are providing homes for unaccompanied immigrant children<\/a>.<\/p>\n