Hundreds of thousands of immigrants with legal status are at risk of losing government health coverage starting Oct. 1, state data shows, signaling that the impact of Medicaid changes in President Donald Trump\u2019s signature legislation from 2025 may be greater than anticipated.<\/p>\n
Many lawfully present immigrants will be among the first people to lose Medicaid coverage under congressional Republicans\u2019 One Big Beautiful Bill Act, which is expected to cut spending by more than $900 billion through 2034 for the state-federal health program for people with low incomes or disabilities. The law will strip many more immigrants of their Affordable Care Act plan subsidies and Medicare coverage next year.<\/p>\n
Those losing their health benefits who were previously eligible include refugees of war, asylees who fled persecution, victims of sex trafficking, and interpreters who risked their lives assisting U.S. service members in Afghanistan \u2014 all of whom are in the country with the federal government\u2019s permission. The law does not affect coverage for a few groups, including those who hold green cards.<\/p>\n
The Congressional Budget Office, the nonpartisan budget scorekeeper, estimated the law\u2019s changes eliminating Medicaid eligibility for many noncitizen adults with legal status would lead to about 100,000 more immigrants being uninsured by 2034<\/a>.<\/p>\n KFF Health News asked several states how many Medicaid enrollees they had identified as being at risk of losing coverage under the provision. More than 281,000 immigrants from nine states and the District of Columbia are expected to lose Medicaid in October.<\/p>\n While some may be able to obtain coverage elsewhere, the state numbers suggest hundreds of thousands of immigrants nationally are at imminent risk of becoming uninsured.<\/p>\n The CBO declined to comment.<\/p>\n Florida alone identified nearly 177,000 immigrants who would no longer qualify for the state\u2019s Medicaid program starting in October, said Anna Holaday, a spokesperson for the Florida Department of Children and Families. The agency verified the enrollees\u2019 immigration status through government databases and sent notices to people to give them an opportunity to provide more information proving they remain eligible, Holaday said.<\/p>\n Arizona predicts nearly 28,000 could lose eligibility. New Jersey expects 15,000 to 25,000 of its noncitizen residents to lose their Medicaid coverage. In North Carolina, it\u2019s about 29,000, and in Washington state it\u2019s 11,000. Final numbers from states on how many Medicaid enrollees have been terminated from the program won\u2019t be available until later this fall.<\/p>\n Lawmakers rely on the CBO to understand the budgetary and economic impacts of proposed legislation. Yet the federal agency did not publish estimates on the One Big Beautiful Bill Act\u2019s impact on noncitizens enrolled in Medicaid until a month after Congress passed the bill and Trump signed it into law.<\/p>\n Much of the attention around Medicaid changes in the law has centered on implementation of work requirements as a new condition of eligibility for many enrollees starting in January. The CBO estimates the requirements will increase the number of uninsured Americans by about 5 million by 2034.<\/p>\n Without health coverage, immigrants are likely to lose access to doctors, prescription drugs, and most other medical services. They still could qualify for coverage of emergency care under a separate program known as Emergency Medicaid.<\/p>\n \u201cI came here to live a better life,\u201d said Ahin, a refugee who left war-torn Syria for Turkey in 2011 and came to the U.S. in October 2024. She spoke with KFF Health News on the condition that she be identified by only her first name, out of concern for her privacy and security.<\/p>\n Soon after arriving in the U.S., she developed severe abdominal pain that required intestinal surgery. Those costs, along with ongoing visits to specialists, were covered by Medicaid.<\/p>\n \u201cI\u2019m really worried about this,\u201d she said. \u201cIt\u2019s truly a terrible situation.\u201d<\/p>\n Ahin, 25, said she doesn\u2019t know what she will do if she needs to go to the hospital \u2014 she wouldn\u2019t be able to pay the bill. She lives in a small apartment in New Jersey with her mother. Medicaid has also been vital to her mother, who has asthma.<\/p>\n Health Benefits Wane for Immigrants<\/strong><\/p>\n The federal government required states to notify immigrants who will soon lose coverage, but immigrant rights advocates say some states did not begin sending letters until September. That\u2019s given enrollees little time to react, including to respond if the state was mistakenly ending their coverage.<\/p>\n Cutting off Medicaid coverage is just the first move to drop government health benefits provided to many lawfully present immigrants. Under a change starting in January, the CBO estimates, about 1 million will lose eligibility for government subsidies to buy individual health coverage on Affordable Care Act marketplaces by 2034. And they will also lose access to Medicare, a change expected to affect about 100,000 immigrants, the agency forecasts.<\/p>\n Trump has argued that taxpayer-funded programs should be reserved for American citizens. As Congress debated the legislation in May 2025, the White House put out a news release<\/a> with the misleading claim that the One Big Beautiful Bill Act would remove Medicaid coverage for people who are in the country without authorization.<\/p>\n Under long-standing law, people who are in the country without authorization do not qualify for the general Medicaid program that is funded by state and federal dollars.<\/p>\n The health coverage cuts are part of a broader Trump strategy to send a message that immigrants are not welcome in the United States, said Ben D\u2019Avanzo, senior strategist for federal advocacy at the National Immigration Law Center. The Trump administration has also moved to kick people with legal status off the Supplemental Nutrition Assistance Program, or SNAP, and tried to do the same with the children\u2019s program Head Start until a federal judge intervened.\u00a0<\/p>\n In addition to green card holders, people under age 19 and immigrants from Cuba, Haiti, or certain Pacific Island countries will not see<\/a> their Medicaid coverage affected by the law.<\/p>\n A Few States Try To Fill in the Gaps<\/strong><\/p>\n Some states are staving off the coverage loss using their own money. California expects about 148,000 immigrants to lose Medicaid coverage. But the state is spending $365 million for a separate program to keep them covered until July 2027, according to Tony Cava, a spokesperson for the California Department of Health Care Services.<\/p>\n New York and Pennsylvania also have state-funded health coverage for many of the immigrants who are affected.<\/p>\n Carlos Alarc\u00f3n, health and public benefits policy manager with the California Immigrant Policy Center, an advocacy group, said taking away health coverage for immigrants will affect the health of the state as a whole. The fewer people who have access to healthcare, the easier it will be for contagious diseases to spread, as happened during the covid pandemic, he said.<\/p>\n Alarc\u00f3n said he hopes the state-funded coverage will be extended under California\u2019s next governor. Polling released in September <\/a>showed Democrat Xavier Becerra, secretary of the Department of Health and Human Services under President Joe Biden, leading Republican Steve Hilton in the gubernatorial race. Becerra has vowed<\/a> to issue an executive order to maintain health coverage for every Californian affected by federal cuts.<\/p>\n \t\t<\/p><\/a>\n California\u2019s next governor will face tough decisions on a highly controversial piece of healthcare policy: what to do about health coverage for the more than 1.4 million low-income residents without legal status. Democrat Xavier Becerra and Republican Steve Hilton present starkly different choices as public opinion wavers.<\/p>\n \u201cI believe there\u2019s folks in the legislature that will really want to fight to make sure that we restore things as much as we can,\u201d Alarc\u00f3n said.<\/p>\n Refugee assistance groups say they have been trying to educate people in their communities and direct them to health clinics that are government-funded or free.<\/p>\n \u201cWe\u2019ve just been scrambling trying to find free medical care,\u201d said Julianna Larsen<\/a>, co-founder of the Arizona Refugee Center<\/a>. \u201cTo not be a welcoming place is the most un-American thing I\u2019ve ever experienced.\u201d\u00a0\u00a0<\/p>\n Andrea Mendez Perez, director at Interfaith-RISE, a refugee resettlement organization in southern New Jersey, said the Trump administration has elongated the process for people to get green cards and is now taking away coverage from those without them. Before 2025, it typically took about six months to qualify for a green card, documentation that allows a foreign national to live and work permanently in the United States, she said. Today, it\u2019s well over a year.<\/p>\n For many of these immigrants on Medicaid, losing their ability to get their prescribed medications \u201cis a life-or-death situation,\u201d Mendez Perez said.<\/p>\n Ahin, the Syrian refugee, applied for permanent residency soon after arriving in the U.S. two years ago. Mendez Perez said she should have her green card by now, which would have spared her from being dropped under the GOP law. \u201cShe is stuck in the middle and has no control.\u201d<\/p>\n Colleen McCauley, policy and advocacy director at the Camden Coalition, a nonprofit that helps connect people to healthcare in southern New Jersey, said the loss of coverage is devastating.<\/p>\n \u201cNone of them did anything wrong,\u201d McCauley said, \u201cand they are losing coverage.\u201d<\/p>\n<\/div>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" Hundreds of thousands of immigrants with legal status are at risk of losing government health coverage starting Oct. 1, state data shows, signaling that the impact of Medicaid changes in President Donald Trump\u2019s signature legislation from 2025 may be greater than anticipated. Many lawfully present immigrants will be among the first people to lose Medicaid…<\/p>\n","protected":false},"author":0,"featured_media":15808,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-15807","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15807"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15807"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/15807\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/15808"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15807"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15807"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15807"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}In California Governor\u2019s Race, Voters Face Stark Choice on Immigrant Healthcare<\/a><\/h2>\n