Pull to refresh
Logo
Daily Brief
Following Why Sign Up
Refugees and legal immigrants lose Medicaid under 2025 budget law

Refugees and legal immigrants lose Medicaid under 2025 budget law

Rule Changes

H.R. 1 restricts coverage to green card holders; an estimated 280,000 lose coverage in October

Today: Refugees and legal immigrants lose Medicaid coverage

Overview

Updated 56 minutes ago

On October 1, refugees, asylum seekers, and other legal immigrants began losing Medicaid coverage across the country. The change comes from H.R. 1, the Republican budget bill passed last summer, which restricted the program to green card holders and a few other groups.

An estimated 280,000 people lost coverage this month, according to KFF Health News. More cuts arrive in January, when roughly 1 million immigrants lose eligibility for Affordable Care Act subsidies and about 100,000 lose Medicare.

Why it matters

Refugees are more likely than other groups to have serious health conditions; losing coverage cuts off access to doctors, prescription drugs, and ongoing treatment.

Questions about this story

Free account needed to ask — your question is kept and asked for you right after sign-up. Answers are public.

No questions yet — be the first to ask.

Key Indicators

280,000
People losing Medicaid in October
KFF Health News analysis of the H.R. 1 eligibility changes.
1 million
Immigrants losing ACA subsidies by 2034
Congressional Budget Office projection for the January 2027 change.
100,000
Immigrants losing Medicare access
Congressional Budget Office forecast for the same January change.

Voices

Curated perspectives — historical figures and your fellow readers.

Ever wondered what historical figures would say about today's headlines?

Sign up to generate historical perspectives on this story.

Log in Sign Up

People Involved

MR
Mustafa Rfat
Professor of social work, University of Nebraska at Omaha
Former refugee from Iraq, now a U.S. citizen
DP
Drishti Pillai
Director of immigrant health policy, KFF
Documenting the impact of the H.R. 1 changes
 Mark Schaefer
Mark Schaefer
Vice president of system innovation and financing, Connecticut Hospital Association
Warned about rising uncompensated care costs

Organizations Involved

KFF (Kaiser Family Foundation)
KFF (Kaiser Family Foundation)
Nonpartisan health policy research organization
Tracking the impact of the Medicaid eligibility changes

KFF (formerly the Kaiser Family Foundation) researches health policy and produces the KFF Health News analysis cited in coverage of the October 2026 coverage loss.
Connecticut Department of Social Services
Connecticut Department of Social Services
State agency
Administering the coverage loss in Connecticut

The Connecticut agency estimated that about 3,200 noncitizens in the state would lose Medicaid coverage on October 1.

Timeline

July 2025 January 2027

3 events Latest: Today

  1. ACA subsidies and Medicare changes take effect

    Upcoming Policy change

    Roughly 1 million immigrants lose Affordable Care Act subsidy eligibility; about 100,000 lose Medicare access.

  2. Refugees and legal immigrants lose Medicaid coverage

    Today Policy change

    An estimated 280,000 people lose coverage as the new eligibility rules take effect nationwide.

  3. Republicans pass H.R. 1, the One Big Beautiful Bill Act

    Legislation

    The budget bill changes 'Alien Medicaid Eligibility,' restricting coverage to green card holders and a few other groups.

Scenarios

1

Congress restores Medicaid for refugees

Unlikely Resolves by Q2 2027

Discussed by: Mustafa Rfat, who hopes Congress reverses course

Advocates and refugee organizations push for legislation restoring Medicaid eligibility for refugees and asylum seekers. A bill would need to pass both chambers and be signed into law, a steep climb given the current Congress passed the restriction.

2

States build their own coverage programs

Possible Resolves by End of 2027

Discussed by: Drishti Pillai of KFF; Connecticut and Washington are already creating options

A few states are creating state-funded coverage for affected immigrants. Most states face tight budgets and larger Medicaid cuts in January, which may limit how many follow.

3

Changes stand; immigrants remain uninsured until green card status

Likely Resolves by Jan 1, 2027

Discussed by: KFF Health News and the Congressional Budget Office

Without federal or state action, affected immigrants remain without comprehensive coverage until they obtain green cards. The CBO projects about 100,000 more uninsured immigrants by 2034.

Historical Context

2 moments from history that rhyme with this story — and how they unfolded.

August 1996

Welfare Reform Act (1996)

Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act, which barred most legal immigrants from Medicaid and food stamps for their first five years in the country. The law also created the modern Temporary Assistance for Needy Families program.

Then

Many states created their own programs to fill the gap for immigrants.

Now

Some restrictions were later rolled back for children and pregnant women, but the five-year bar shaped immigrant benefit policy for decades.

Why this matters now

The 1996 law was the last major restriction of immigrant benefit eligibility before H.R. 1.

August 2019

Public Charge Rule (2019)

The Trump administration expanded the public charge test, making it harder for immigrants who used Medicaid, food stamps, or housing assistance to get green cards. The rule was challenged in court.

Then

The rule was blocked in several courts and created widespread fear among immigrants about using public benefits.

Now

The Biden administration rescinded the rule in 2022, but the chilling effect on benefit use persisted.

Why this matters now

It shows how benefit eligibility rules shape immigrant decisions about seeking care, a dynamic now repeating under H.R. 1.

Sources

(7)
+1
NPR KFF Health News The Washington Post The Seattle Times Connecticut Public VPM Central Florida Public Media