Health Care

Hilbert bill blocking Medicaid for illegals clears first hurdle

February 11, 2026

Ray Carter

Legislation preventing illegal aliens from accessing taxpayer-funded Medicaid coverage has easily cleared its first legislative hurdle.

House Bill 4423, by House Speaker Kyle Hilbert, requires the Oklahoma Health Care Authority to verify a Medicaid applicant’s citizenship status using the Systematic Alien Verification for Entitlements (SAVE) system. Under the bill, no benefits may be provided to an applicant until legal status is confirmed.

If the SAVE status indicates a person is not legally in the United States, the bill then requires the Oklahoma Health Care Authority to notify the Office of the Attorney General, where officials will review the case and notify the United States Immigration and Customs Enforcement (ICE) Agency if an applicant’s legal status in the United States is unverifiable.

“What we’re trying to ensure is that, yes, that this is only going to citizens of the United States of America,” said Hilbert, R-Bristow.

HB 4423 passed out of the House Public Health Committee on a 4-1 vote that broke along party lines, with Republicans in support and a Democrat opposed. The legislation now proceeds to the House Health and Human Services Oversight Committee.

Hilbert is also the author of House Bill 4422, which imposes similar requirements on the Oklahoma Department of Human Services when reviewing applications for other welfare programs, including the food-stamp program.

That bill passed through its first committee last week with strong support.

Oklahoma officials are working to crack down on illegal-immigrant access to taxpayer-funded welfare programs as federal officials are urging greater review nationwide.

In a release issued on May 27, 2025, officials with the federal Centers for Medicare & Medicaid Services (CMS) announced increased federal oversight to stop states from misusing federal Medicaid dollars to cover health care for individuals who are in the country illegally.

Under federal law, federal Medicaid funding is generally only available for emergency medical services for noncitizens with questionable immigration status who would otherwise be Medicaid-eligible, but officials in the Trump administration said some states have pushed the boundaries, putting taxpayers on the hook for benefits that are not allowed.

“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” said CMS Administrator Dr. Mehmet Oz. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice—CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”

CMS is ramping up financial oversight to identify and stop improper spending, including through focused evaluations of select state Medicaid spending reports and in-depth reviews of select states’ financial management systems.

CMS officials have urged all states to immediately examine and update internal controls, eligibility systems, and cost allocation policies to ensure full compliance with federal law. Any improper spending on noncitizens is subject to recoupment of the federal share.

A report released this month by the Center for Immigration Studies estimated that 53 percent of households headed by immigrants—including naturalized citizens, legal residents, and illegal immigrants—used one or more major welfare programs, based on the 2024 Survey of Income and Program Participation (SIPP). In comparison, just 37 percent of U.S.-born households were using welfare.

The report estimated that 39 percent of immigrant-headed households were on Medicaid, compared to 27 percent for households headed by U.S.-born individuals.

Officials with the Center estimated that 61 percent of households headed by illegal immigrants use at least one major welfare program, although officials with the Center stated that they “have no evidence that this is due to fraud.”

Instead, the Center’s report noted, “Illegal immigrants can receive welfare on behalf of their U.S.-born children, and illegal-immigrant children can receive free/reduced price school lunch/breakfast and WIC directly. A number of states provide Medicaid to some illegal-alien adults and children, and a few provide SNAP.”

“Assuming our estimates are correct,” the report stated, “the SIPP data indicates that use of the welfare system by illegal-immigrant households is extremely common.”

[Photo credit: Oklahoma House of Representatives]