Federal officials awarded $197 million in direct grants for research studies and state and local programs aimed at making it easier for “undocumented persons” — immigrants in the U.S. illegally — to gain access to government health care services and programs, according to Open the Books (OTB).

“Illegal immigrants have benefitted from at least $197 million in direct federal healthcare-related grants since fiscal year 2021,” the Illinois-based nonprofit government watchdog reports. “This figure does not include indirect spending on illegal immigrants via Medicaid, which was estimated by the Congressional Budget Office [CBO] to be around $27 billion from FY 2017-2023, nor does it account for education spending that benefits illegal immigrants and their children, which amounts to an estimated $70 billion annually.” The OTB analysis covers the period from 2021 to the present.

“While some elected officials insist illegal immigrants cannot access federal spending, the nearly $200 million identified by [Open the Books] covers grants for healthcare outreach and provisioning, along with supposedly scientific studies aimed at expanding federal and state programs to include illegal immigrants. Such spending has been reduced considerably since Donald Trump took office but [Open the Books] researchers still identified $13 million in relevant spending since February 2025,” the report continued.

The authors of the OTB report cautioned that “the funds identified are unlikely to reflect the full universe of federal spending on illegal immigrants; these findings merely reflect grants and programs that explicitly use terms like ‘undocumented’ in their descriptions.”

Operating for the purpose of making “every dime” of public spending at all levels of government accessible to the general public “online in real time,” OTB has filed more than 50,000 public information law requests for spending data at the federal, state, and municipal levels. The result is the largest, most comprehensive, and continually updated compilation of government spending ever compiled.

Among the multiple examples of federal grants to support research efforts cited by OTB is the $4.2 million given by the National Institutes for Health (NIH) in 2023 to Stanford University to study the potential impact of California’s guaranteed annual income experiment on “the fundamental causes of cancer inequities.” The California program has 2,000 participants, including multiple illegal immigrants.

Another NIH grant exposed by the OTB found that investigators provided $2.5 million in 2022 to the University of California at Los Angeles (UCLA) to study “the use of reproductive healthcare among Asian immigrant women,” including “undocumented Asians, who experience greater barriers to access than their documented peers.”

Much of the federal program grants uncovered by OTB came from the Health Resources and Services Administration (HSRA) within the Department of Health and Human Services (HHS).

“The Health Resources and Services Administration (HRSA), a sub-agency of The Department of Health & Human Services, spent at least $75.6 million on grants serving illegal immigrants. HRSA’s mission is to ‘provide health care to people who are geographically isolated and economically or medically vulnerable,” according to OTB.

“The bulk of HRSA funding serving illegal immigrants flows through the Ryan White HIV/AIDS Bureau, which provides medical care for low-income people with HIV. Ryan White was a young man who died of AIDS after a transfusion with infected blood in 1990.”

Among the HSRA grants OTB highlighted was $833,594 for the Northern Nevada HIV Outpatient Program. This program offers a long menu of services, including “targeted high-risk HIC testing, HIC medical care, primary care, medical case management, treatment adherence counseling, specialty care referrals, pharmacy services, non-medical case management, behavioral health counseling, retention in care activities, transportation assistance, and housing rental assistance.” The program’s grant application states that 7% of its clients are illegal immigrants.

Another highlighted federal program making such grants was the HHS Substance Abuse and Mental Health Services Administration (SAMHSA), which dispatched $31 million to state and local programs that include “undocumented” individuals among beneficiaries during the period covered by the OTB analysis.

In one such grant, $4 million was given to the Communities Wellness Centers USA in Long Beach, California, for an expansion project that “will increase access to behavioral health and substance use disorder services, as part of their comprehensive integrated primary care model, to the minority low-income black/African American, Cambodian, and Latinx refugee and undocumented populations of Southern Los Angeles County.”

Los Angeles County is estimated to have approximately 1.1 million undocumented individuals within its borders.