*Content warning: This article discusses sexual assault, self harm, and distressing conditions in detention.

The second Trump administration has detained and removed a record number of individuals, reaching nearly 600,000 by July 11, 2026. More than 65,000 people remain in custody under Immigration and Customs Enforcement and Customs and Border Protection, with daily arrest targets set at 2,000. Over several years American Oversight has filed Freedom of Information Act requests to examine living conditions and medical services inside these facilities. Recent records obtained through FOIA provide fresh insight while also prompting additional concerns.

A FOIA request yielded detailed figures on offsite medical, dental, and pharmacy services delivered to individuals in ICE and CBP custody from January 1 through October 7, 2025. The extensive dataset, also examined by the Los Angeles Times, supplies new context on serious health needs that detention centers cannot address internally and illustrates the range of conditions treated by outside providers.

The figures prompt important questions about whether the ICE Health Service Corps can guarantee prompt, high-quality care, especially since providers have gone unpaid for offsite services since last autumn.

Together with the raw data, American Oversight presents early observations and the issues that emerged during review.

The records reveal urgent medical conditions arising in custody

The claims are categorized by illness and diagnosis using standard ICD-10-CM codes. Each claim represents a provider request for reimbursement. Review of the 233,772 claims points to numerous health crises that demanded immediate attention while individuals remained in ICE and CBP custody.

From January through October 2025 the data list 520 claims for acute myocardial infarction, 453 for cerebral infarction, and 482 for intracranial injuries including concussions and brain hemorrhages. Providers submitted 450 claims for hypertensive crisis and 936 for acute kidney failure. Additional claims cover throat or chest pain (6,028), syncope and collapse (1,276), convulsions (1,428), and epilepsy with recurrent seizures (1,272). IHSC reimbursed more than six million dollars for this care.

These examples represent only a portion of the conditions documented. The volume of claims illustrates how delayed or denied treatment can produce life-threatening outcomes when ICE cannot promptly compensate outside providers.

Conditions inside detention facilities

Independent observers have long reported substandard conditions in immigration facilities. The new claims add further detail. Between January and October 2025 there were 417 claims for dehydration, 301 for frostbite, 126 for starvation, 191 for malnutrition, and 112 for heat-related illness. Care for these preventable problems cost taxpayers nearly 800,000 dollars.

Injury claims were also numerous: 3,421 for head injuries, 3,226 for knee and lower-leg injuries, 2,016 for ankle and foot injuries, and 1,955 for wrist, hand, and finger injuries. Treatment exceeded 5.1 million dollars. Five claims noted death resulting from brain injury.

Additional records raise further alarms. Claims referenced adult sexual abuse (123), adult rape (20), child sexual abuse (27), adult physical abuse (17), child physical abuse (1), and other assaults. Forty-nine claims noted prior adult physical or sexual abuse, and five involved examination after forced sexual exploitation. Claims also covered attempted suicide (96), suicidal ideation (216), and other intentional self-harm including poisoning and hanging.

Infectious-disease claims included 1,501 for tuberculosis, 1,631 for HIV, 883 for other bacterial infections such as sepsis, and 1,096 for influenza and pneumonia. Additional claims addressed viral hepatitis, malaria, COVID-19, and sexually transmitted infections. Recent measles and tuberculosis outbreaks at facilities in Arizona, Texas, and Colorado underscore the same care gaps reflected in the data.

Total reimbursement for all claims surpassed 96 million dollars, illustrating both the human and financial costs of current detention practices.

Are vulnerable groups receiving sufficient care?

The records also shed light on populations that may face heightened risk. Hundreds of claims involved pregnancy complications, labor, delivery, and postpartum care, including 111 claims for high-risk pregnancy supervision and 54 for delivery. Nine claims appeared to involve newborn treatment.

Mental-health claims were likewise elevated: 2,985 for schizophrenia and related disorders (nearly 13 million dollars), 2,696 for mood disorders (more than 2.65 million dollars), and 1,434 for anxiety and stress-related conditions. Claims also documented treatment needs for intellectual disabilities, autism spectrum disorder, and developmental conditions.

Further claims covered chronic illnesses requiring ongoing management, such as hypertensive disease (7,579), ischemic heart disease (1,359), Alzheimer disease, Parkinson disease, and dementia. Nine encounters involved palliative care. Additional records referenced insulin, dialysis, supplemental oxygen, hearing loss, and vision impairment.

ICE has not paid offsite providers for care after October 2025

IHSC arranges outside care when services are unavailable inside facilities. For more than two decades the Department of Veterans Affairs processed these claims. In fall 2025 VA ended the arrangement, citing the need to redirect resources to veteran programs. ICE then awarded two no-bid contracts worth more than 110 million dollars to Acentra and Ardent. Nevertheless, providers have not received payment for services rendered on or after October 1, 2025, even though Acentra reportedly received nearly 45 million dollars. VA later agreed to process claims with service dates through September 30, 2025, while ICE seeks new vendors.

Offsite providers may cease treating detainees

ICE described the sudden loss of claims processing as an absolute emergency that could delay critical care and place lives at risk. Because providers remain unpaid, some have already declined further services. A rural Pennsylvania emergency crew answered 43 calls at one facility after October 2025 yet received no payment by June 2026. Reports from California describe similar disruptions and outright denial of care at multiple sites.