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Hundreds of Thousands of Legal Immigrants Face Medicaid Loss
Confirmed
In Short: Starting Oct. 1, hundreds of thousands of legal immigrants, including refugees and trafficking victims, will lose Medicaid coverage under Trump's One Big Beautiful Bill Act.
Hundreds of thousands of legal immigrants are set to lose Medicaid coverage starting October 1, according to state data. The One Big Beautiful Bill Act, signed into law by President Donald Trump, will strip many noncitizens of their Medicaid eligibility.
Florida alone identified nearly 177,000 immigrants who will no longer qualify for Medicaid, said Anna Holaday, spokesperson for the Florida Department of Children and Families.
The federal government did not publish estimates on the impact of the law on noncitizens until a month after its passage. Immigrant rights advocates say some states did not begin notifying affected individuals until September.
The law will cut spending by over $900 billion through 2034 for Medicaid, affecting many lawfully present immigrants, including refugees, asylees, and trafficking victims.
While the law does not affect those with green cards, it will strip many more immigrants of their ACA plan subsidies and Medicare coverage next year.
More than 281,000 immigrants from nine states and the District of Columbia are expected to lose Medicaid in October. Some may find coverage elsewhere, but hundreds of thousands are at risk of becoming uninsured.
The Congressional Budget Office estimated the law’s changes would lead to about 100,000 more immigrants being uninsured by 2034.
Two lawsuits filed Monday challenge new federal guidance that could affect green card applicants who have used Medicaid or food assistance. The administration says immigrants who have used public benefits will have a more difficult time getting permanent residence.
New York Mayor Zohran Mamdani announced the city is suing the federal government to preserve immigrants’ access to Medicaid and food stamps.
The new immigration policy allows Medicaid, food assistance, and housing aid to be considered a disqualifying 'public charge.
What this adds
The impact of the Medicaid changes may be greater than initially anticipated.
The lawsuits and city actions highlight the contentious nature of the policy changes.
What's confirmed
- 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’s signature legislation from 2025 may be greater than anticipated.
- KFF Health News asked several states how many Medicaid enrollees they had identified as being at risk of losing coverage under the provision.
- Florida alone identified nearly 177,000 immigrants who would no longer qualify for the state’s Medicaid program starting in October, said Anna Holaday, a spokesperson for the Florida Department of Children and Families.
- Yet the federal agency did not publish estimates on the One Big Beautiful Bill Act’s impact on noncitizens enrolled in Medicaid until a month after Congress passed the bill and Trump signed it into law.
- 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.
- Many lawfully present immigrants will be among the first people to lose Medicaid coverage under congressional Republicans’ 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.
- 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.
- The law does not affect coverage for a few groups, including those who hold green cards.
- The Congressional Budget Office, the nonpartisan budget scorekeeper, estimated the law’s changes eliminating Medicaid eligibility for many noncitizen adults with legal status would lead to about 100,000 more immigrants being uninsured by 2034.
- More than 281,000 immigrants from nine states and the District of Columbia are expected to lose Medicaid in October.
- 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.
What's still developing
- Test your knowledge with our new weekday mini crossword By Phil Galewitz, Andrew Jones, and Claudia Boyd-Barrett — KFF Health News Hundreds of thousands of immigrants with legal status are at risk of losing government health coverage starting Oct.
- The rule change, set to take effect Friday, likely would make it tougher for many immigrants to obtain green cards if they use or are deemed likely to need public benefits such as food stamps, Medicaid or housing vouchers.
- But the Trump administration's pending change does not specify which safety net programs should be considered - meaning non-cash benefits like Medicaid and housing vouchers can be.