*Content warning: This article discusses sexual assault, self harm, and distressing conditions in detention.
The second Trump administration has arrested, detained, and deported a record number of people: nearly 600,000 as of July 11, 2026. There are over 65,000 people currently being detained by Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP), and the administration has set a target of 2,000 immigration arrests per day. For years, we have been using Freedom of Information Act (FOIA) requests to learn more about the conditions people are being held in and the kind of treatment they are receiving. Recently, we gained a key piece of information — and it raises as many questions as it answers.
Through a FOIA request, we obtained data on offsite medical, dental, and pharmacy care and services provided to people in ICE and CBP custody between Jan. 1 and Oct. 7, 2025. This massive trove of information, also reported on by the LA Times, offers new details about the serious healthcare needs that often cannot be met in detention facilities, providing a snapshot of the thousands of medical conditions treated by offsite providers.
This data raises serious questions about how the ICE Health Service Corps (IHSC) ensures detainees receive timely access to high-quality medical care, given that they have not paid the healthcare providers who have provided offsite services since last fall.
Along with the data itself, we are laying out our initial findings and the questions that arose from our analysis.
The data shows the serious and urgent medical conditions people experience in detention
The claims data we obtained is organized by disease and medical condition using standardized diagnostic labels known as ICD-10-CM codes. A medical claim is a request for payment that a provider submits in order to be reimbursed for the treatment or services they provided. Our analysis of these 233,772 claims suggests there are a significant number of people who experienced health emergencies that required immediate medical attention while in ICE and CBP custody.
For example, between January and October 2025, there were 520 claims related to acute myocardial infarction (heart attacks), 453 claims related to cerebral infarction (ischemic strokes), and 482 claims related to intracranial injuries like concussions, hemorrhages, and traumatic brain injuries. It appears that IHSC reimbursed providers for 450 claims for hypertensive crisis and 936 claims for acute kidney failure. There were also an alarming number of claims related to people experiencing pain in the throat or chest (6,028), syncope and collapse (1,276), convulsions (1,428), and epilepsy and recurrent seizures (1,272) while in ICE and CBP custody. Our analysis shows that IHSC paid providers well over $6 million for this care.
This is the tip of the iceberg — the data shows hundreds of other conditions that may require immediate medical care. This information demonstrates how medical neglect can have life-threatening consequences if care is delayed or denied due to ICE’s ongoing inability to process claims and pay providers.
What are the conditions in detention facilities?
Journalists, state agencies, members of Congress, and human rights organizations have regularly documented and uncovered inhumane conditions in detention facilities. Our analysis reveals several other alarming details that tell us more about the conditions people face while in ICE and CBP custody. There were 417 claims for dehydration between January and October 2025. Detainees were also treated for frostbite (301 claims), starvation (126 claims), malnutrition and other nutritional deficiencies (191 claims), and the effects of heat and light (e.g., heatstroke and heat exhaustion) (112 claims). The records don’t specify the circumstances that led to these otherwise preventable conditions, but the resulting medical treatment cost taxpayers nearly $800,000.
There were also many claims related to injuries. For example, between January and October 2025, there were 3,421 claims for treatment for “injuries to the head” among those in ICE and CBP custody, totaling over $2 million. There were similarly high numbers of claims related to injuries to the knee and lower leg (3,226), injuries to the ankle and foot (2,016), and injuries to the wrist, hand, and fingers (1,955). Treating these injuries cost over $5.1 million. There were dozens of other types of injuries in the data we obtained; five claims specifically mention death due to brain injury.
The data we obtained contains other details that raise serious concerns. We identified claims related to adult sexual abuse (123), adult rape (20), child sexual abuse (27), adult physical abuse (17), child physical abuse (1), and other forms of assault. There were 49 claims that indicated people in ICE and CBP custody had personal histories of adult physical and sexual abuse as well as five claims for “examination and observation” for victims following forced sexual exploitation. We identified other claims for attempted suicide (96 claims), suicidal ideation (216 claims), and other serious methods of intentional self-harm — including poisoning and asphyxiation due to hanging — among those in ICE and CBP custody.
There were also a number of claims related to infectious and parasitic diseases. Looking at the data we obtained, providers filed 1,501 claims related to tuberculosis and 1,631 for HIV. There were 883 claims for “other bacterial diseases” such as sepsis and meningitis, and 1,096 related to influenza and pneumonia. We identified claims for dozens of other types of infectious and parasitic diseases including viral hepatitis, malaria, COVID-19, and sexually transmitted infections. Over the past six months, there have been numerous reports of disease spread at immigration detention facilities, including measles outbreaks in Arizona and Texas and confirmed cases of tuberculosis in Colorado. Many have raised alarms that immigration detention facilities are failing to provide the exact type of medical care that was documented in the data we reviewed.
Treatment for these conditions — which may have been caused or worsened by unsafe detention conditions — cost taxpayers millions of dollars. The total cost for all the claims in the data we obtained was over $96 million. In addition to the human cost of these injuries and illnesses, taxpayers are shouldering the financial burden of the administration’s immigration agenda and the subpar and potentially dangerous conditions that people face while detained.
Are vulnerable populations receiving adequate care in ICE detention?
The data we are releasing also provides a glimpse into how certain populations may be at greater risk of medical neglect while in detention. Pregnant, nursing, and postpartum people in ICE detention centers, for example, are not receiving proper medical care. We reviewed hundreds of claims submitted between January and October 2025 related to people suffering from pregnancy complications and disorders related to pregnancy, childbirth, and the postpartum period while in ICE and CBP custody. This included 111 claims for supervision of high risk pregnancy, 289 claims for supervision of normal pregnancy, 54 claims related to delivery, and 120 claims for complications of labor and delivery. We also identified nine claims that seem to indicate that newborns were treated while in ICE and CBP custody.
We also noted a high number of medical claims related to mental, behavioral, and neurodevelopmental disorders. For example, between January and October 2025, there were 2,985 claims for schizophrenia and other non-mood psychotic disorders. It appears that IHSC reimbursed providers nearly $13 million for these claims. During the same period, treatment related to mood disorders was also high — approximately 2,696 claims that cost over $2.65 million. There were also 1,434 claims related to anxiety, dissociative, stress-related, and other nonpsychotic mental disorders. Concerningly, we reviewed several claims indicating that people with intellectual disabilities, developmental disorders, autism spectrum disorder, and other related conditions needed offsite medical treatment while in ICE and CBP custody.
Detainees have also documented their inability to get medication for conditions like diabetes and cancer on time, sometimes with devastating consequences. The data we obtained revealed numerous conditions that would require continued medical treatment and attention. This included, for example, hypertensive diseases (7,579 claims), ischemic heart diseases (1,359 claims), and other forms of heart disease (2,095 claims). It also appears that people in ICE and CBP custody with Alzheimer’s, Parkinson’s, and dementia required offsite medical care. There were also nine “encounters” related to palliative care, which raises questions as to whether ICE and CBP detained people who were seriously ill. We reviewed several claims suggesting that people required access to insulin, renal dialysis, supplemental oxygen, and other enabling machines and devices while in ICE and CBP custody. The claims data also indicated that many people in detention facilities experienced hearing loss, visual disturbances, or blindness.
ICE hasn’t paid offsite medical providers for treatments or services after October 2025
IHSC is responsible for providing health care services to people in detention facilities across the country. When someone needs medical care that is not available onsite, IHSC refers them to community providers outside detention facilities, like nearby hospitals or emergency departments. IHSC is supposed to reimburse those “offsite” providers for care provided to people detained by ICE and CBP.
For more than twenty years, the Department of Veteran Affairs (VA) processed medical, dental, and pharmacy claims for offsite care on behalf of IHSC and CBP. Through FOIA, we obtained the agreement between ICE and VA that facilitated this arrangement. However, in the fall of 2025, VA abruptly stopped processing these claims. In August 2025, VA told ICE that the “termination [was] necessary to reallocate resources to support mission-facing programs serving Veterans, families, caregivers, and survivors,” according to the notification we obtained via FOIA.
To replace the sudden void created by VA, ICE awarded two no-bid contracts for over $110 million to Acentra and Ardent last fall, to process claims and reimburse offsite providers on behalf of IHSC and CBP. However, it appears that providers have not been paid for care provided on or after Oct. 1, 2025, despite Acentra reportedly receiving nearly $45 million, and might not start issuing payments for months to come. In May 2026, VA stepped back in to process claims with dates of service through Sept. 30, 2025. Publicly available government contracting information suggests that ICE has started looking for new vendors who could assist with claims processing.
These offsite medical providers might stop treating people in ICE and CBP detention
When VA stopped processing claims, that created — in ICE’s words — an “absolute emergency,” because “lack of this support will delay critical medical care” as the “health, welfare, and lives of [people] in ICE and CBP custody are significantly at risk.” ICE even warned that the abrupt termination could lead to “medical complications or loss of life.”
Since these offsite providers are not receiving payment, there is a risk that they could stop treating detainees in urgent need of medical care. A nonprofit emergency services crew in rural Pennsylvania, for example, has responded to 43 calls at a detention center since October 2025 but, as of June 2026, had not been paid for a single response. A recent report on immigration detention in California noted that this interruption in claims processing “has caused widespread disruption in the provision of appropriate medical care at facilities in California.” ICE’s failure to pay these bills has led to some medical providers denying services to detainees.
Members of Congress recently opened an investigation following reports that people died while in ICE custody after not receiving appropriate offsite care.
The need for accountability and transparency has never been higher
This data shows the extensive medical needs of people in ICE and CBP custody. But it also raises the larger question of whether people are receiving this care given that ICE has not paid providers in months — and what continued payment delays could mean for people in detention.
Experts warn that delayed care has already contributed to the skyrocketing number of deaths in detention. As of August 2026, at least 55 people have died in ICE custody since the beginning of President Trump’s second term. ICE also plans to stop reporting deaths of newly released detainees.
At a time when deaths in detention are already at record levels and still climbing, we need answers. We sent FOIA requests to the Department of Homeland Security (DHS), ICE, and VA to better understand why claims processing changed, how this has impacted people detained by ICE and CBP, how many outstanding claims or unpaid bills exist, how DHS selected new contractors while skipping a competitive bidding process, and who at DHS and ICE were involved in these decisions. We have also filed FOIAs with DHS, ICE, and the Department of Health and Human Services for records on deaths in custody, requests for postmortem reviews, and details concerning inadequate treatment and disease outbreaks at detention facilities. We are still waiting for these agencies to respond.
