(AP) – New restrictions enacted by the United States government have stripped Medicaid coverage from certain foreign nationals who reside legally in the country, including refugees and victims of human trafficking.
The overhaul of the health assistance program for the poor or disabled, which took effect on October 1, removed from Medicaid what is estimated to be hundreds of thousands of foreign nationals living legally in the United States, many of whom work and pay taxes.
The measure is part of sweeping Medicaid changes under President Donald Trump’s 2025 tax cut and fiscal policy law, with many provisions slated to take effect early next year. The changes are projected to reduce the number of people with health insurance by about 7.5 million, according to the 2025 estimate from the Congressional Budget Office.
Advocates contend that, without Medicaid, people will be unable to afford private medical expense insurance, or will delay care or end up in emergency rooms, which will add pressure to the health care system. For immigrants, the cuts could be felt more acutely, as they compound the effects of other government attempts to restrict their access to public assistance as part of a broader immigration crackdown.
“This is about telling every immigrant in the United States that they are not welcome here and that they should leave,” said Ben D’Avanzo, a senior strategist at the National Immigration Law Center — which has pushed litigation against the Republican administration over its immigration agenda.
Refugees, asylum seekers, and victims of trafficking and domestic violence are among those who have lost coverage. Green card holders were not affected.
Lauren Bis, a White House spokesperson, said in a statement that “immigrants must be able to support themselves without turning to benefit programs already overburdened, paid for by working American taxpayers.”
D’Avanzo noted that many people who have lost coverage may not realize it until they need medical care. But for some, the change was felt immediately.
Loss of Medication Supplies
In Tucson, Arizona, Maria Chacón has been caring for her son Jesus for nearly five years since a car crash at age 17 left him unable to breathe on his own. He requires a mechanical ventilator, a feeding tube, and daily medications, and must be turned every two hours to prevent bedsores. Chacón said that sometimes he opens his eyes.
The family is from Mexico and entered the United States on a T visa, offered to trafficking victims, in 2018.
Chacón explained that Medicaid has helped cover nearly $25,000 a month for her son’s care, including a small stipend for her and her husband as long‑term caregivers. She noted that doctors have told them that even if both worked around the clock, they could not cover the cost of his care.
“Since that day I haven’t been able to sleep. We haven’t been able to eat or anything. We wonder what we are going to do,” Chacón said.
Jesus takes medications that, according to Chacón, cost about $7,000 a month. The supply runs out in mid-October. Without coverage, she doesn’t know how her son will survive.
Chacón learned only a few days before the cuts that she would lose the benefit. She called state Medicaid offices to appeal. Although she is in the process of obtaining permanent residency, Medicaid coverage would take effect five years after it is approved.
The government recently reactivated a federal rule that could deny permanent residency to immigrants who use public assistance, including food stamps, Medicaid, housing vouchers, and other programs.
Chacón believes the Medicaid cuts are part of the administration’s hardening stance toward immigrants. She said her son is not in a condition to travel.
Millions More Will Lose Medicaid Coverage
Medicaid, jointly funded by the states and the federal government, has become a political flashpoint during Trump’s second term. The president has pushed to eradicate what he describes as fraud in the program. In July, the administration delayed more than $1 billion in Medicaid payments to California and Minnesota, citing concerns about fraud. Critics argued that the move targeted states led by Democratic politicians.
As more people are removed from Medicaid, the federal government is expected to cut program spending by about $911 billion, according to KFF, a nonprofit health policy research organization.
In Arizona, officials said that 29,000 legally residing immigrants were removed from Medicaid rolls on October 1. In Florida, estimates approach 177,000. In total, more than 281,000 immigrants across nine states and the District of Columbia are projected to lose Medicaid coverage, according to KFF.
As more states implement various coverage restrictions, it is expected that 7.5 million people will lose coverage by 2034, according to an analysis by the Congressional Budget Office.
Without coverage, people will turn to emergency rooms for care. When people delay seeking medical attention, conditions can worsen and become more costly to treat.
“Ultimately, it does raise costs for the states because when these people seek care for something that could have been prevented, since they could not go to the doctor due to lack of insurance, they are most likely to end up in a hospital, in an emergency room,” said Carmen Feliciano, vice president of policy and advocacy at UnidosUS, a Latino civil rights organization.
UnidosUS partners with community organizations to help provide health care, but Feliciano said they are already overwhelmed and will not be able to backstop the number of people who will lose health coverage in the coming months.
“We’re not going to have the capacity to serve all the people who need it,” she added.
