ICE has not paid for detainee medical care for 7 months

The termination of payments to providers has coincided with a massive spike in detainee deaths and medical crises.

(Photo by Jacek Boczarski/Anadolu via Getty Images)

On October 3, 2025, the Trump administration abruptly stopped paying third-parties for medical care provided to detainees in the custody of Immigration and Customs Enforcement (ICE). Third-party providers are used to provide “medically necessary” care including “dialysis, prenatal care, oncology, [and] chemotherapy,” according to ICE.

A document posted to an official government contracting website by ICE on November 12, described the situation as an “absolute emergency” that needed to be resolved “immediately” to “prevent any further medical complications or loss of life.”

According to the ICE Health Service Corps (IHSC), payments to third parties were supposed to resume on April 30, 2026. ICE has contracted with a private firm, Acentra Health, to process reimbursements.

But when April 30 arrived, payments to third party medical providers did not resume. Instead, Acentra quietly updated its website stating that “[c]laims payment services are estimated to begin during the second quarter of [sic] 2026 calendar year (April — June).”

For decades, routine processing of third party medical reimbursement were processed for ICE by the Department of Veterans Affairs (VA), through the VA Financial Service Center (VAFSC). This did not divert resources from the VA as it was compensated by ICE for this service. The arrangement was terminated with no notice after the VA’s role was criticized by right-wing activists.

In a statement, a VA spokesperson says the department is ensuring claims are being processed during the transition. “[The Department of Homeland Security] has signed a new contract to process these claims and is currently onboarding the vendor,” VA spokesperson Pete Kasperowicz told KFF Health News in February. “Meanwhile, VA is supporting this transition until May to ensure claims are processed appropriately.”

A source at the VA with direct knowledge told Popular Information that this is false. “No claims are being processed,” the VA source said. “We’ve done zero work to support [ICE] since they couldn’t pay us.” The source spoke on the condition of anonymity because they are not authorized to speak to the media.

Kasperowicz’s claims are also directly contradicted by the IHSC website, which stated in an April 24 update to providers, “[p]lease continue to hold all claim submissions while IHSC works to bring the new system online in the interim.” The IHSC website announced on October 3, 2025, “Do not mail or submit electronic claims to the VAFSC until further notice. All mail will be returned to sender.” All subsequent communications about the VA’s role repeated this guidance.

For more than seven months, third parties have not been able to be reimbursed for medical services provided to ICE. This has coincided with a massive spike in detainee deaths and medical crises.

As ICE cuts off payments for medical care, detainee death skyrocket

The decision to stop reimbursing third parties for the medical care of ICE detainees has coincided with a significant spike in deaths, according to data released by the agency.

From 2018 to 2024, the average number of people who died in ICE custody annually was 8.9. That includes a spike in 2020 related to the onset of the COVID pandemic. In 2025, 33 people died in ICE custody, including 12 after the medical reimbursements stopped.

The trend is accelerating. In the first four months of 2026, 18 people have died in ICE custody. Since ICE stopped medical reimbursements on October 3, 2025, people have been dying in ICE custody at a rate of 51.7 people annually. This is more than five times the death rate before the policy was implemented.

The ICE detainee population has increased since Trump took office in 2025, from about 40,000 to 60,000 people. But even adjusting for the population increase, the current death rate is many times the historical average.

In a few cases, the deaths were attributed to a violent incident at a facility. But most deaths were attributable to a medical condition. Beyond the data, there are numerous examples of individual cases that suggest essential medical care is being denied to ICE detainees.

On December 3, 2025, Francisco Gaspar-Andrés died at the Camp East Montana detention facility in Fort Bliss, Texas of liver failure. According to a report in the San Francisco Chronicle, for two months before his death Gaspar-Andrés “went to the medical unit nine times, complaining of symptoms including bloody stool and bleeding gums.” But he “was sent back from visits to the medical unit with allergy, heartburn and indigestion medications and diagnosed with influenza despite repeatedly testing negative.” By the time he was finally transported to a hospital on November 16, doctors were unable to save his life.

After touring the Camp East Montana detention facility on April 6, Congressman Gabe Vasquez (D-NM) said that the “conditions that I saw inside the detention facility today are beneath our American values.” Vasquez heard from detainees who said “you practically have to be down on the ground, dying… before you receive medical care.”

On January 27, attorney Eric Lee said that at the Dilly Immigration Processing Center in Texas, one of his clients “had appendicitis, collapsed in the hallway, was vomiting from pain, and the officials told him, take a Tylenol and come back in three days.” Hayam El Gamal, another one of Lee’s clients held at Dilly, “was refused a CT scan by center officials for a lump in her chest.” According to an April 15 federal court filing, El Gamal, a mother of five, “has been pleading for medical attention for the abnormal growth, which has caused severe pain, since February 15.” The court filing alleges ICE is “are systematically denying Ms. El Gamal medical care” and the denial “poses an urgent threat to Ms. El Gamal’s health and potentially her life.”

Andrea Pedro-Francisco, an asylum seeker from Guatemala, was detained by ICE on February 5 and eventually sent to El Paso Service Processing Center. According to Amnesty International, she “has a large ovarian cyst and was scheduled for surgery on February 11.” But since being placed in detention, “she has not received adequate medical care.” There are indications that the cyst has grown considerably and Pedro-Francisco “is experiencing severe abdominal and lower back pain.”

An April 13, 2026, report in The Detroit News suggests that detainees at the North Lake Processing Center, which holds about 1500 people, are not receiving necessary care. Ruth Pujols Beltre, a detainee at the facility with a history of cardiovascular issues, said she has “swollen legs, a tingling sensation in her hands and trouble breathing at times.” When she reported her symptoms to North Lake staff they “only offered her over-the-counter pain relievers like Ibuprofen and acetaminophen.” Ruby Robinson, managing attorney at the Michigan Immigrant Rights Center, said one client detained at the same facility “wasn’t receiving any care for a festering wound that remained after an amputation as a result of diabetes.”

Meanwhile, ICE has defended the standard of medical care provided to detainees. “For many illegal aliens this is the best healthcare they have received their entire lives,” a spokesperson told ABC News.