The Romanian cardiac patient had been four months out of an emergency triple bypass when ICE picked him up in July, and the first thing he learned about federal detention was that nobody had worked out yet who was supposed to hand him his sixteen daily pills. Two days passed at the Baltimore field office without medication. After a hospital trip and a second discharge, the count came back wrong: eight of sixteen. He was on a video call with his daughter in August when he stroked, and he lost speech for four days. A federal judge ordered him released in November.
By then the agency holding him was spending, in acting director Todd Lyons’s own May accounting, “almost half a billion dollars” on detainee health care this year, up from a roughly $390 million bill in fiscal 2023. The same agency had spent the previous year dismantling the Office of the Immigration Detention Ombudsman, the small federal body whose job was watching conditions like his, and shut it entirely in early May, citing Congress’s failure to fund it. The detainee population that office was no longer watching had grown from roughly 40,000 a year earlier to more than 75,000 by mid-January.
KFF Health News and Associated Press reporters pulled the dockets of roughly 33,000 habeas corpus cases filed from January 20, 2025 through March 2026, of which about 4,400 carried the original petitions attached. Inside those, more than 300 cases across at least 33 states held sworn allegations of delayed, denied, or deficient medical care, from CoreCivic facilities in Mojave, California and Lumpkin, Georgia, to a Geo Group facility in Folkston, Georgia, to state and county jails contracted into the system in Florida and Wyoming.
The allegations were not independently verified, and the reporters say the set is not statistically representative. They are also specific enough, and consistent across thirty-three states and a dozen contracted facilities, to describe a pattern rather than a set of isolated complaints. A Guatemalan construction worker at CoreCivic’s Stewart Detention Center, shackled in a transport vehicle, slammed into a metal armrest, then developed an E. coli infection sleeping on a concrete floor near leaking toilets, and was hospitalized far enough away that his treating doctor told him he had narrowly escaped amputation of the left leg. He is now a legal permanent resident, no longer able to lift heavy things, and unsure whether he can go back to construction. CoreCivic’s spokesperson said staff had found no records of a case matching that description.
A Honduran mother on blood-pressure medication was denied her pills at a Florida facility and ended up hospitalized. A Mexican national named Jose-Antonio Segismundo was held for more than seven months across Florida and Georgia facilities, including the Geo Group site at Folkston, on abdominal cancer; his wife told reporters the treatment she heard about was Tylenol, and that her husband had since been deported home to a village in Oaxaca to begin his search for care again. A California federal judge ordered ICE to take a man showing signs of prostate cancer to a specialist. ICE didn’t. The agency’s lawyers later told the court the missed appointment was an “internal scheduling error.” A man with one functioning eye, dependent on twice-daily glaucoma drops, has been losing what remained of his vision. “It now often looks like I’m seeing through gauze,” he told the court.
Whatever else can be said about these cases, “ICE standards” is the phrase doing the work in the contractor response to nearly every one of them. CoreCivic told reporters its standards were met and that “nothing matters more” than detainee welfare. Geo Group said it “follows ICE standards.” Those are the standards a Romanian cardiac patient was getting eight of sixteen prescribed medications under, the standards a pregnant detainee was denied prenatal care under, the standards a postpartum woman was denied sanitary pads under, the standards an advanced stomach-cancer patient was denied a pillow under, the standards an Albanian man in New Mexico pulled out his own tooth under. The federal office whose job was to ask what those standards actually meant inside a Lumpkin or a Folkston exam room was closed two weeks before Lyons mentioned the half-billion figure.
DHS acting chief medical officer Sean Conley has said in the past that detainees receive “timely and appropriate medical care from the moment they enter ICE custody,” and that the care is “better, more responsive” than many had received in their lives. DHS, asked to respond to the AP and KFF findings six days before publication, didn’t.
About seventy percent of the people inside ICE facilities have no criminal conviction, and immigration proceedings are civil, not criminal. They are still moved across the country without warning, which is how a Russian man with painful gallstones at a Texas facility never made it to his scheduled surgeon. He kept getting transferred.
Whether the United States should be holding 75,000 people on civil immigration grounds is a political question. Whether the agency that decided to hold them can keep them alive and medicated while paying nearly half a billion dollars a year to do it is a different one, and the case file offers more than 300 sworn allegations across thirty-three states answering it badly. The independent federal watchdog with the standing to walk into a CoreCivic facility and ask the medical director why a man with one eye is going blind on the federal dime existed until last year. It does not now.
What’s left is the litigation route, and federal judges are doing their share of the work. A judge in Ohio said during a hearing that lost glasses should be replaced. A judge in California ordered the specialist appointment, then watched the agency miss it. A judge in November ordered the Romanian patient released after the stroke. The detainee’s attorney quoted in the report described the change in flat terms. “Before, you could attempt to work with folks on the government side and maybe shame them into doing the right thing,” he said. “Now, it’s sort of like anything you want done you have to go to court and sue over.”
Fifty-one detainees have died in ICE custody since the second Trump inauguration, on DHS’s own count. The case files that gave KFF and AP their reporting are the survivors. The contracts are still being written. The ombudsman office is not coming back unless someone in Washington decides it should.
Nearly half a billion dollars buys a lot of things. On the evidence in the court file, it has not been buying a Romanian cardiac patient sixteen of his sixteen daily pills.