Wednesday, American Oversight released new records raising urgent questions about whether the Trump administration is meeting its obligation to provide adequate medical care to people in Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) custody after it disrupted the longstanding system responsible for processing payments for offsite treatment. Federal law mandates that ICE provide medical care for people in its custody.
As reported by the Los Angeles Times, the records we obtained document more than 233,000 medical, dental, and pharmacy claims totaling more than $96 million that the Department of Veterans Affairs (VA) processed on behalf of ICE’s Health Service Corps (IHSC) last year, illustrating the extraordinary scale and seriousness of the medical care flowing through the system immediately before payments stopped.
The VA’s decision to suddenly end its decades-long practice of processing claims 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.”
The records include previously undisclosed data documenting 233,772 claims processed by VA on behalf of IHSC and CBP between Jan. 1 and Oct. 7, 2025, as well as the interagency agreement that previously facilitated this arrangement and VA’s August 2025 notice to ICE that it would terminate its longstanding claims processing support in order to reallocate resources to other programs.
The newly released claims data provides an unprecedented snapshot of the serious healthcare needs that often cannot be met in federal detention facilities — at a time when the detained population has skyrocketed, nearly doubling between January 2025 and January 2026. The records include claims associated with treatment for serious medical conditions, including heart attacks, strokes, traumatic brain injuries, acute kidney failure, mental health crises, infectious diseases like tuberculosis and HIV, pregnancy-related care, dehydration, heat stroke, starvation, suicide attempts and suicidal ideation, and physical and sexual abuse, among many others.
“These records expose some of the potential human consequences of an immigration detention system that has grown increasingly punitive and abusive under the Trump administration. They document hundreds of thousands of medical claims for people in ICE and CBP custody receiving treatment for everything from starvation and heat stroke to suicide attempts and alleged physical and sexual abuse,” said our Executive Director Chioma Chukwu. “The data illustrates both the immense medical needs of people held in detention and the extraordinary scale of the care that was flowing through the system before payments came to a halt. Given the Trump administration’s well-documented record of preventable deaths and other serious harms linked to inadequate medical care in immigration detention, the public has every right to know whether human beings in government custody are receiving the medical care they need. That imperative is only more urgent as the administration rapidly expands detention at enormous taxpayer expense while continuing to dismantle oversight and accountability. A federal government that chooses to deprive people of their liberty must also assume responsibility for providing adequate health care. These records raise urgent questions about whether it is meeting that obligation.”
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 despite their previous $110 million sole source awards.
Because of ICE’s inability to effectively and efficiently reimburse providers, there is a risk that detainees may not receive urgent, critical medical care. 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. Experts warn that delayed care has already contributed to the skyrocketing number of deaths in detention.
Previously, we partnered with the ACLU and Physicians for Human Rights to release “Deadly Failures: Preventable Deaths in U.S. Immigration Detention,” which revealed that 95 percent of deaths in ICE custody during the first Trump administration were preventable or potentially preventable with proper medical care.
