KFF HEALTH NEWS

Federal Medicaid funding ends Oct. 1 for refugees, asylees and other legal immigrants without green cards; nine states and DC count 281,000 losing coverage

Immigration enforcement

Political Guyentist · October 1, 20262 min read

KFF HEALTH NEWS

The Congressional Budget Office projected the change would leave 100,000 more immigrants uninsured by 2034.

Starting Thursday, Oct. 1, the One Big Beautiful Bill Act (the Republican tax-and-spending law passed in 2025) stops federal Medicaid payments for many immigrants who are in the U.S. legally. That includes refugees, asylees (people granted asylum), trafficking victims and Afghan interpreters. State data gathered by KFF Health News counts more than 281,000 people in nine states and DC expected to lose Medicaid (the joint federal-state health program for low-income people) in October.

Where the largest counts are:

Florida
nearly 177,000
Arizona
nearly 28,000
New Jersey
15,000-25,000

What the Oct. 1 cutoff leaves in place for affected immigrantsEmergency Medicaid still pays for emergency care, though the law trims its federal match for expansion adults3 details

Emergency Medicaid still pays for emergency care, though the law trims its federal match for expansion adults
States must give at least 10 days' notice and a fair hearing before ending anyone's coverage
States have until Jan. 4, 2027 to actually terminate current enrollees; until then, keeping them costs state dollars only

What we’re less sure of6 of 8 claims

Medium
More than 281,000 people in nine states and DC are expected to lose Medicaid in October.
Attributed to state data gathered by KFF Health News. It is a compilation of state projections, and final termination counts are not yet available.
Medium
Florida accounts for nearly 177,000, Arizona nearly 28,000 and New Jersey 15,000-25,000 of those losing coverage.
State-reported figures compiled by KFF Health News. The New Jersey number is a range estimate and the counts are not final.
Medium
The Congressional Budget Office projected the change would leave 100,000 more immigrants uninsured by 2034.
An explicitly attributed CBO forecast, corroborated by KFF's CBO analyses (the 100,000 Medicaid/CHIP figure versus 1.4 million across all programs).
Medium
New York must keep covering affected immigrants with state money under a longstanding court ruling.
Plausible (the Aliessa precedent), but neither the story nor the listed sources clearly cite the ruling. The KFF Key Facts source refers only to a New York budget proposal.
Low
No lawsuit or injunction is blocking this provision.
An unsourced sweeping negative. Courthouse News reports a PRWORA injunction on a different provision, which only partly informs this claim.
Medium
The same law cuts more than $900 billion from Medicaid through 2034, and its work requirement alone would leave about 5 million more people uninsured by 2034.
Attributed to CBO scoring. The listed CBO letters support a 7.8 million total uninsured figure but do not directly state the $900 billion or 5 million work-requirement numbers.

Red take

Federal Medicaid belongs to immigrants who hold a green card, the document that makes a stay permanent, and the One Big Beautiful Bill Act, the Republican tax-and-spending law, finally draws that line while emergency care stays paid. The Congressional Budget Office projects 100,000 more uninsured by 2034, counted after some find job or other coverage. Without the line, federal taxpayers keep funding open-ended coverage for status that is not yet permanent.

Blue take

Afghan interpreters, trafficking victims and refugees, people the United States chose to protect, lose their federal Medicaid on Oct. 1 under the One Big Beautiful Bill Act, the Republican tax-and-spending law. Nine states and DC already count more than 281,000 losing coverage, nearly 177,000 in Florida alone. Congress should restore it, or the protection this country granted them will stop at the clinic door.