Medicaid eligibility limits for many legal immigrants begin Oct. 1 under 2025 budget law

Starting Oct. 1, hundreds of thousands of immigrants with legal status are at risk of losing Medicaid coverage, according to state data gathered by KFF Health News. 1 2 The change comes from the One Big Beautiful Bill Act, which is expected to cut Medicaid spending by more than $900 billion through 2034. 1 Those affected include refugees, asylees, sex-trafficking victims and Afghan interpreters, while green card holders are among the groups not affected. 1 2

KFF Health News found more than 281,000 immigrants in nine states and the District of Columbia expected to lose Medicaid in October, including nearly 177,000 in Florida. 1 2 The Congressional Budget Office estimated the changes will leave about 100,000 more immigrants uninsured by 2034. 1 2 California expects about 148,000 people to lose Medicaid but is spending $365 million on a separate program to keep them covered until July 2027; New York and Pennsylvania also have state-funded coverage for many of them. 1

Immigrant advocates said some states did not begin sending notices until September, leaving little time to respond, and affected people may still qualify for Emergency Medicaid. 2 More losses are expected from January, when about 1 million are projected to lose marketplace subsidies and about 100,000 to lose Medicare access by 2034, per the CBO. 1 Trump has argued taxpayer-funded programs should be reserved for citizens; the report calls a May 2025 White House claim about removing coverage for people without authorization misleading, since they already do not qualify for general Medicaid. 1 2