Thousands of Immigrants with Legal Status Lose Medicaid as Sweeping GOP Cuts Hit

Thousands of refugees and some other immigrants with legal status lost Medicaid coverage on Oct. 1, marking one of the first significant coverage reductions under the GOP’s One Big Beautiful Bill Act.

States and advocacy organizations had warned people who were previously eligible that they would no longer qualify. Those affected include refugees, asylees without green cards, domestic violence survivors and victims of sex trafficking.

“This is a real shift that’s going to create a serious gap in access to healthcare services,” said Adriana Cadena, executive director of the Protecting Immigrant Families Coalition. She said people who have survived war, natural disasters or sexual assault will be among those losing coverage.

Advocates said the restrictions could cost people access to doctors, medications and treatments for diabetes and other chronic diseases. Providers could lose longtime patients while hospitals expect more uninsured emergency room visits.

Gold. Upgraded. Buy real gold from $1. Store it in America. Sell it with one click.

Hospitals must provide emergency care regardless of immigration status and receive reimbursement through Emergency Medicaid. The anticipated increase in emergency visits could raise costs across the health system.

The law does not affect green card holders or several other small immigrant groups. It also leaves existing state options intact for covering children and pregnant immigrants with federal matching money.

The Medicaid restrictions are the first of several provisions projected to remove people from government funded health coverage. Starting next year, more than 1 million immigrants are projected to lose Affordable Care Act subsidies and Medicare coverage.

This Could Be the Most Important Video Gun Owners Watch All Year

President Trump signed the One Big Beautiful Bill Act into law in 2025 after he and congressional Republicans made it their signature domestic policy legislation. The law is projected to reduce Medicaid spending by $900 billion through 2034 through eligibility restrictions, work requirements and cost sharing.

The administration promoted the legislation as a way to remove immigrants without legal status from Medicaid. “The One, Big, Beautiful Bill is a generational chance to protect Medicaid for Americans by removing at least 1.4 million illegal immigrants from the program,” the White House said in May 2025.

Immigrants without legal status were already ineligible for federally funded health coverage. The law also restricted immigrants’ access to food stamps, Medicare and the Children’s Health Insurance Program.

The nonpartisan Congressional Budget Office estimated that the Medicaid changes would cause roughly 100,000 lawfully present immigrants to lose health insurance. Advocates argued that the actual number could be considerably higher because green card applications are moving slowly.

U.S. Citizenship and Immigration Services reports that processing an application for permanent residence from a refugee admitted more than a year ago takes an average of 30 months. During that wait, some immigrants with legal status could lose Medicaid coverage.

Ben D’Avanzo, senior strategist at the National Immigration Law Center, called the Republican approach “shocking.” “These are people who are among the most vulnerable and among the most vetted categories of immigrants,” D’Avanzo said.

Federal officials said the changes ensure government money is spent on Americans while requiring immigrants to support themselves. “Immigrants must be able to support themselves and not depend on benefits paid for by hard-working American taxpayers. President Trump and this administration will always put American citizens first,” White House spokesperson Lauren Bis said in a statement.

Steven Camarota, director of research at the Center for Immigration Studies, supports curtailing immigrants’ use of welfare programs but said Medicaid restrictions would produce relatively modest savings. He argued that larger savings would require changes to the broader immigration system.

“If we really want legal immigrants to use less welfare we would need to have a system that selects future immigrants based on skills who are unlikely to need welfare,” Camarota said.

People losing coverage could seek primary and preventive care at Federally Qualified Health Centers, which serve patients regardless of immigration status and charge sliding scale fees based on income. They may also purchase Affordable Care Act coverage, though advocates said cost is often a barrier.

The same immigrants losing Medicaid eligibility will become ineligible for regularly subsidized Affordable Care Act plans on Jan. 1. Congressional Republicans also allowed enhanced premium subsidies under the law to expire last year.

Shanteny Jackson, executive director of the Virginia Community Health Worker Association, said roughly 6,000 lawfully present immigrants in Virginia lost Medicaid. Some could qualify for a new program through the state’s Affordable Care Act exchange.

That program is limited to households earning between 138% and 250% of the federal poverty level. The range is between $22,025 and $39,900 for an individual, or between $45,540 and $82,500 for a family of four.

Cadena also raised concerns about mixed status households and possible effects on American citizen children. She said children remain eligible as citizens, but parents losing coverage might mistakenly believe their children have also lost access.

Gold is the oldest answer. SoundMoney makes owning it as easy as the apps you already use.