The termination of a contract between the Department of Veterans Affairs (VA) and the Department of Homeland Security (DHS) for processing medical claims of immigration detainees has raised concerns about detainee health risks and payment delays for care providers. The change has disrupted the payment system that reimbursed healthcare providers for medical services delivered to individuals held in federal immigration custody.

Historically, the VA handled medical claims for detainees in the custody of Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP). This arrangement faced criticism from some Republican lawmakers during the Biden administration, who argued that it diverted resources from veterans’ care. Following the return of the Trump administration, the VA formally notified ICE on August 19, 2025, that it would cease processing detainee medical claims effective February 28, 2026, citing a need to reallocate department resources.

Shortly after a right-leaning advocacy group filed a lawsuit seeking documents related to resource use within the VA, the department ended its claims processing on October 3, 2025. ICE then awarded no-bid contracts to two firms, Acentra Health and Ardent Group, to take over claims related to healthcare and pharmacy services, respectively. The transition aimed to maintain continuity of care amid concerns that any payment delays could lead providers to refuse services, jeopardizing access to essential treatments such as dialysis, prenatal care, and chemotherapy.

ICE currently detains more than 65,000 individuals as it conducts record-high arrest operations. The agency relies on approximately 3,000 community and hospital providers, which submit around 300,000 claims annually for detainee medical services. VA records indicate that during the January to October 2025 period, ICE claims comprised $77.3 million, about 80% of the total, with CBP claims amounting to $19 million. The average cost for off-site care per detainee was approximately $260, substantially lower than the roughly $2,700 federal prisons spent per inmate for external medical care.

Common medical claims for ICE detainees included screenings for tuberculosis and other infectious diseases, treatment for hypertension, chest pain, diabetes, and serious mental health conditions such as psychosis and schizophrenia. For CBP detainees, a significant portion of claims related to traumatic injuries, including fractures and concussions. Other notable claims involved pregnancy and maternal care, seizures, and mental health emergencies such as self-harm. The highest individual claim documented was $292,199 for leukemia treatment.

Medical experts highlight the substantial healthcare needs among detained immigrants, noting many enter custody with chronic illnesses or develop serious conditions while detained. Dr. Amy Zeidan, an emergency medicine specialist focused on immigrant health, emphasized that the cessation of claim payments could severely disrupt access to necessary hospitalizations and specialized care.

Despite plans to resume claims processing by April 2026 through Acentra Health, providers have reported not receiving payments and have been instructed by ICE to withhold claim submissions while a new system is implemented. Representatives from Acentra confirm their role is limited to developing the claims platform, with processing dependent on government authorizations and avoiding delays caused by funding lapses and federal shutdowns.

Congressional members, including Reps. Mark Takano and Delia Ramirez, have questioned DHS and VA leadership about the timeline for restoring payments, the status of reimbursed claims, and any health consequences linked to the interruption. They express concern over at least 23 detainee deaths this year, up from 33 last year, which they believe may be related to reduced access to off-site medical care.

Homeland Security has declined to comment directly but asserts it provides comprehensive medical and mental health services within detention facilities. ICE officials describe the disruption in claims processing as creating an emergency, highlighting the urgent need to establish a reliable system to prevent further medical complications or loss of life among detainees.