Major Medicaid Changes Narrow Health Coverage for Lawfully Present Immigrants
Starting October 1, 2026, hundreds of thousands of lawfully present immigrants lose access to federally funded Medicaid and CHIP coverage. The changes restrict eligibility to green card holders, Cuban-Haitian entrants, and COFA migrants.
New Federal Rules Reshape Immigrant Health Access
Beginning October 1, 2026, hundreds of thousands of lawfully present immigrants will lose access to federally funded health coverage under changes mandated by federal law. The One Big Beautiful Bill Act, signed into law on July 4, 2025, restricts eligibility for Medicaid, the Children's Health Insurance Program (CHIP), and coverage through the Affordable Care Act (ACA) marketplaces.
Who Loses Coverage?
Many groups of lawfully present immigrants will end eligibility, including asylees, refugees, and survivors of domestic violence and trafficking. People who may lose federally funded full-scope Medicaid include refugees and asylees, humanitarian parolees, survivors of human trafficking, survivors of domestic violence, and Special Immigrant Visa holders.
Who Remains Eligible?
Medicaid eligibility will be restricted to lawful permanent residents, certain Cuban and Haitian immigrants, COFA migrants lawfully residing in the U.S., and lawfully residing immigrant children and pregnant adults in states that waive the five-year waiting period.
What to Know About ACA Marketplace Coverage
Lawfully present noncitizens with incomes below 100% of the federal poverty level who are barred from Medicaid because of their status are no longer eligible for premium tax credits to enroll in coverage. However, emergency Medicaid remains available regardless of status for acute medical conditions.
If you are a refugee, asylee, or hold a humanitarian visa or parolee status and currently have Medicaid, contact your state health agency immediately to understand whether you qualify for alternative coverage such as state-funded plans or ACA marketplace options. Green card holders with established residency will generally retain eligibility. New arrivals should verify their specific immigration category and state of residence to determine coverage options, as some states offer supplemental programs.
Sources
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