A sudden disruption in how the federal government pays for offsite medical care for immigration detainees has sparked concerns over potential delays in life-saving treatment, according to internal government records released by the watchdog group American Oversight.
The Department of Veterans Affairs ended a decades-long agreement to process medical, dental, and pharmacy claims for the Immigration and Customs Enforcement Health Service Corps and Customs and Border Protection last autumn. Prior to the shutdown, the VA handled 233,772 claims totaling more than $96 million between January 1 and October 7, 2025.
Internal documents reveal that ICE officials strongly opposed the VA’s August 2025 notice of termination, calling the loss of payment processing an “absolute emergency.”
In communications obtained by the watchdog, ICE warned that losing the system would delay critical care and that the “health, welfare, and lives of [people] in ICE and CBP custody are significantly at risk,” adding that the decision could lead to “medical complications or loss of life.”
The VA stated it terminated the arrangement to reallocate its internal resources elsewhere.
The claims data provides a detailed look at the volume and nature of offsite care requested for individuals in federal custody during a period when the detained population nearly doubled. The records detail treatments for severe conditions, including heart attacks, strokes, traumatic brain injuries, acute kidney failure, tuberculosis, HIV, heat stroke, dehydration, starvation, suicide attempts, and alleged physical and sexual abuse.
To replace the VA system, ICE awarded two no-bid contracts worth over $110 million to the firms Acentra and Ardent last fall. However, records and public contracting data indicate that offsite healthcare providers have faced significant payment backlogs for services rendered on or after October 1, 2025, despite tens of millions of dollars already being disbursed to contractors. To address the backlog, the VA temporarily agreed in May 2026 to process older claims dated prior to October 2025, while ICE has begun searching for new vendors.
Reports from independent monitoring groups, including a recent review of California detention centers, indicate that the payment breakdown has led some private medical providers to refuse services to detainees. Members of Congress have since launched an investigation into the matter following reports of deaths in ICE custody linked to delayed or denied offsite care.
American Oversight Executive Director Chioma Chukwu argued that the federal government remains legally obligated to ensure proper medical treatment for those it holds.
“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,” Chukwu said in a statement. “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.”
Chukwu added, “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.”
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