Joshua Budhu
@jbudhu.bsky.social
Neuro-Oncologist at Memorial Sloan Kettering Cancer Center, Health Disparities Researcher
6/6 🧵 We argue that states should have the flexibility to determine what works best for their populations.
A one-size-fits-all federal approach undermines effective, evidence-based care for immigrant communities — and burdens the hospitals that care for them.
A one-size-fits-all federal approach undermines effective, evidence-based care for immigrant communities — and burdens the hospitals that care for them.
October 6, 2025 at 3:06 PM
6/6 🧵 We argue that states should have the flexibility to determine what works best for their populations.
A one-size-fits-all federal approach undermines effective, evidence-based care for immigrant communities — and burdens the hospitals that care for them.
A one-size-fits-all federal approach undermines effective, evidence-based care for immigrant communities — and burdens the hospitals that care for them.
5/6🧵Unauthorized immigrants contribute billions to the U.S. health system — more than they receive in care.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
October 6, 2025 at 3:06 PM
5/6🧵Unauthorized immigrants contribute billions to the U.S. health system — more than they receive in care.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
In 2017 alone, net contributions totaled:
$20.8B to Medicare
$21.3B to Medicaid
$14.7B to private insurance
They are net funders, not burdens.
4/6 🧵
Emergency Medicaid spending is tiny:
💰 FY2023 = $3.8B, just 0.44% of total Medicaid ($860B). Even at its pandemic peak, it stayed below 1%. Yet it supports hospitals serving millions with no other coverage options.
Emergency Medicaid spending is tiny:
💰 FY2023 = $3.8B, just 0.44% of total Medicaid ($860B). Even at its pandemic peak, it stayed below 1%. Yet it supports hospitals serving millions with no other coverage options.
October 6, 2025 at 3:06 PM
4/6 🧵
Emergency Medicaid spending is tiny:
💰 FY2023 = $3.8B, just 0.44% of total Medicaid ($860B). Even at its pandemic peak, it stayed below 1%. Yet it supports hospitals serving millions with no other coverage options.
Emergency Medicaid spending is tiny:
💰 FY2023 = $3.8B, just 0.44% of total Medicaid ($860B). Even at its pandemic peak, it stayed below 1%. Yet it supports hospitals serving millions with no other coverage options.
3/6 🧵
Emergency Medicaid was designed to reimburse hospitals for federally required emergency care — but some states have expanded coverage to include essential services like dialysis. This flexibility That flexibility has saved lives and reduced costs
Emergency Medicaid was designed to reimburse hospitals for federally required emergency care — but some states have expanded coverage to include essential services like dialysis. This flexibility That flexibility has saved lives and reduced costs
October 6, 2025 at 3:06 PM
3/6 🧵
Emergency Medicaid was designed to reimburse hospitals for federally required emergency care — but some states have expanded coverage to include essential services like dialysis. This flexibility That flexibility has saved lives and reduced costs
Emergency Medicaid was designed to reimburse hospitals for federally required emergency care — but some states have expanded coverage to include essential services like dialysis. This flexibility That flexibility has saved lives and reduced costs
2/6 🧵
In May 2025, CMS issued new guidance warning states that use federal dollars for care to unauthorized immigrants beyond emergencies could face audits and fund recoupment.
This marks a major shift from decades of state flexibility under Emergency Medicaid.
In May 2025, CMS issued new guidance warning states that use federal dollars for care to unauthorized immigrants beyond emergencies could face audits and fund recoupment.
This marks a major shift from decades of state flexibility under Emergency Medicaid.
October 6, 2025 at 3:06 PM
2/6 🧵
In May 2025, CMS issued new guidance warning states that use federal dollars for care to unauthorized immigrants beyond emergencies could face audits and fund recoupment.
This marks a major shift from decades of state flexibility under Emergency Medicaid.
In May 2025, CMS issued new guidance warning states that use federal dollars for care to unauthorized immigrants beyond emergencies could face audits and fund recoupment.
This marks a major shift from decades of state flexibility under Emergency Medicaid.