The medical care system inside ICE detention has reached a crisis point in 2025-2026, with record deaths, an unprecedented payment freeze to medical providers, and a detained population that has surged 82% while healthcare funding has not kept pace.

The Death Toll

• 2025: 32 people died in ICE custody – the highest in over two decades
• 2026: At least 4 deaths in the first 10 days alone, on pace to meet or exceed 2025
• ACLU finding: 95% of ICE detention deaths between 2017-2021 were preventable with adequate medical care
• Pattern: denied medications, ignored medical emergencies, unqualified staff

The Payment Freeze

In October 2025, ICE stopped paying third-party medical providers for detainee treatment:

• The Department of Veterans Affairs terminated a longstanding agreement to process medical reimbursement claims on October 3, 2025
• ICE instructed providers to hold all claims until at least April 30, 2026
• In 2025, despite an 82% increase in the detained population, only $157 million in claims were processed
• Estimated gap: nearly $300 million between needed medical care and what was actually paid
• Result: immigrants in detention could no longer receive dialysis, prenatal care, oncology, or chemotherapy

ICE Health Service Corps (IHSC)

IHSC is the federal entity responsible for medical care:

• FY2025: Provided direct care to 171,000+ detained people in 17 facilities
• Oversight responsibility: 266,000+ detained people in 217 non-IHSC-staffed facilities (50,700+ beds)
• Budget (2022): Approximately $323.7 million
• Staffing: U.S. Public Health Service deployed nearly 400 officers on monthlong tours to provide basic medical care – some officers reported “moral distress”

Medical Contractors

In non-IHSC facilities (the majority), medical care is provided by private contractors or local government staff, with IHSC oversight:

• Specific contractor identities for individual facilities are not comprehensively documented in public reporting
• Amentum Services Inc. was awarded the Camp East Montana contract in March 2026, partly to address medical care deficiencies at that facility
• EHR modernization: ICE is soliciting a $50-100 million contract for an integrated electronic health records system, with award anticipated Q4 FY2026

Congressional Scrutiny

Senator Jon Ossoff’s investigation found:

• ICE stopped paying for detainee medical care as the population surged
• Widespread neglect documented across facilities
• Democrats decried “meager medical care” during 2026 DHS funding debates

The Structural Problem

The medical care crisis is not incidental – it is structural. The per-bed-day payment model that drives detention expansion does not adequately fund healthcare. When the detained population surges (as it did 82% in 2025), medical care becomes the cost center that gets squeezed. The result: preventable deaths.

Sources

• KFF: Deaths and Health Care Issues in ICE Detention Centers Under the Second Trump Administration
• State of Surveillance: ICE Detention Deaths: 2025 Was the Deadliest Year in Two Decades
• NPR: Public Health Service officers deployed to detention centers suffer ‘moral distress’ (Feb 2026)
• CBS News: ICE stopped paying for detainee medical care as population surged, Ossoff investigation finds
• KFF Health News / CNN: Democrats decry meager medical care for detainees in funding fight (Feb 2026)
• Penn LDI: ICE Facilities Operated Without Qualified Health Staff
• Washington Times: ICE replaces contractor at largest detention camp after scrutiny (Mar 2026)
• WOLA: U.S.-Mexico Border Update: Detention deaths (Jan 2026)