PA 25 Seeks CMS Waiver For Continued Health Care Provider's Tax

The PA 25 health care tax fraud scheme allows Oregon to claim federal dollars for illegal immigrant health care.  This is why Republicans started to wind down the tax fraud scheme in OBBBA  The same tax fraud scheme is used to pay for illegals' health care in at least 11 other states, with California and New York racking up the largest (federally paid) subsidies.  The cost increase of these programs is explosive.  In Oregon, spending on its Medicaid expansion to immigrants regardless of legal status has increased from $ 100 million in FY 21 to $ 1.5 billion in FY 27.

Michigan seems content to pay for illegals' health care in hospital emergency departments with federal dollars, but has not developed a program comparable to Healthier Oregon.  Michigan's hospital emergency department subsidy for illegals is carefully concealed from the public by state government, but probably cost taxpayers something between $ 300 million and $ 500 million per year:

https://dailycaller.com/2025/10/13/oregon-now-spends-more-on-program-offering-free-health-care-for-illegal-immigrants-than-state-police/

Oregon Now Spends More On Program Offering Free Health Care For Illegal Immigrants Than State Police
By Emily Kopp - October 13, 2025
Investigative Reporter

Oregon will spend more in its current budget period on free health care for immigrants regardless of legal status than on state police by $500 million or more, according to state officials and budget documents.

Oregon officials expect to spend $1.5 billion in combined state and federal taxpayer dollars on a program that offers health benefits to illegal aliens from 2025 to 2027. They expect to spend $717 million on Oregon State Police over the same period, the documents indicate.

The state’s health agency, the Oregon Health Authority, said in an email to the Daily Caller News Foundation that the state expects to allocate $1.2 billion to the program — originally named “Cover All People” and now called the “Healthier Oregon Program” (HOP). Oregon lays out budgets in two-year “bienniums.”

The federal government will supply 25% of the funding to provide health benefits to illegal aliens in Oregon, the OHA told the DCNF.

The data emblematizes some of the Democratic stronghold’s policy priorities — facilitating illegal immigrants’ access to health care and reducing criminal crackdowns. These very policies have touched off a government shutdown in Washington, D.C., and protests in Portland.

Medicaid — the joint federal-state program that traditionally provided health services to children, pregnant mothers and disabled adults — formally bars illegal immigrants from receiving benefits.

But some blue states have innovated creative accounting methods to extract federal dollars without the federal restrictions, according to the Paragon Health Institute, a non-partisan policy research group. Blue states will issue taxes on Medicaid insurers and providers, obtain a bundle of federal matching dollars for those funds, then return the taxed money to those institutions, the think tank points out.

Spending on health services for illegal aliens in Oregon has climbed by at least 1100% since the program’s introduction roughly four years ago.

An Oregon report shows a steep jump in spending on its Medicaid expansion to immigrants regardless of legal status.

Lawmakers first introduced the program in 2021 with a $100 million cap. State Medicaid programs benefitted from increased federal matching dollars for the COVID-19 pandemic at that time. The proposal grew out of a racial justice council convened by then-Gov. Kate Brown in 2020 and enjoyed support from a coalition of managed care organizations, hospital groups, pro-abortion groups, medical professional societies, unions and advocacy groups.

In the intervening years, the national illegal immigration population surged under President Joe Biden, the public health emergency ended, and Oregon expanded eligibility to all age groups — causing the cost to balloon.

In October 2024, OHA faced a $260 million budget shortfall, according to the Lund Report, an Oregon-focused health news outlet. About 93,000 people had enrolled in the state’s Medicaid expansion for immigrants regardless of legal status, nearly double the state’s projection of 55,000 enrollees, the report said.

Showdowns In DC, Portland

The policy demands congressional Democrats in DC have named as a prerequisite for reopening the government include dismantling barriers preventing Medicaid dollars from flowing to illegal aliens.

Democrats’ counterproposal to the “clean” continuing resolution (CR) preferred by Republicans to end the government shutdown would unwind several reforms that President Donald Trump signed into law via the One Big Beautiful Bill Act (OBBB) in July.

These provisions included ending the disbursement of higher federal Medicaid match dollars for the emergency care of illegal aliens compared to traditional Medicaid recipients like children — states received a 90% rate for illegal aliens compared to 50% for American citizens — and closing accounting loopholes that allow federal funds to be shunted to state priorities like coverage for illegal immigrants.

Republican House Speaker Mike Johnson has estimated that the rollback of health reforms would cost roughly $192 billion.

In Oregon, an illegal alien need not supply proof of long-term residency in the state in order to receive the taxpayer-sponsored health benefits, according to state resources.

According to the OHA, the federal spending for Oregon’s illegal aliens only covers emergency and pregnancy care that the federal government is required to cover per U.S. law, echoing the arguments of Democratic leaders who say illegal immigrants cannot access federal Medicaid dollars outside of the emergency room.

However the OHA budget document shows the state will obtain federal dollars unfettered by federal rules through creative accounting too.

Oregon pads its state pot of Medicaid funds, funds unfettered by federal rules against dispersing it to illegal aliens, through what it describes as a “tax,” but what really amounts to an accounting loophole. Oregon “taxes” hospitals to obtain funding while tapping federal matching funds to pay back the hospitals the “taxed” amount in full.

Meanwhile in Portland, nightly protests continue outside of an Immigration and Customs Enforcement (ICE) facility.

Attorneys for the state of Oregon and city of Portland have argued in court against the deployment of the National Guard, saying that violent crime in Portland is significantly down.

But on Wednesday, the Portland City Council heard testimony from several small business owners who argued in support of an initiative to revive Portland storefronts amid break-ins, fires, graffiti, shoplifting, public drug use and visible mental health crises. (RELATED: ‘He Needs To Come Out Here’: Chief Border Patrol Agent Dares Dan Goldman To Walk Streets Of Chicago)

“I’ve replaced a total of nine windows, three locks from attempted break-ins, I’ve been spit on, I’ve been punched twice, once resulting in a black eye. I had a man masturbating in my window. I’ve had a gun pulled on me twice — once was last week. I’ve had a knife pulled on me,” said Steve Cook, owner of Portland business Vinyl Resting Place. “When I’m found dead in my shop, I’m gonna be like ‘I told you so.'”