Refugees and Legal Immigrants Lose Medicaid and CHIP Coverage as US Law Takes Effect

Starting Thursday, hundreds of thousands of legally present immigrants in the United States — including refugees, Afghan allies, Ukrainian parolees and survivors of trafficking — lost eligibility for Medicaid and the Children’s Health Insurance Program (CHIP), according to refugee advocacy group Global Refuge.

The change comes from H.R. 1, the “One Big Beautiful Bill Act” signed into law in July 2025. From October 1, federal Medicaid and CHIP funding is restricted to only four categories of non-citizens: green card holders, Cuban and Haitian entrants, migrants from Pacific Island nations under the COFA agreements, and — at states’ option — lawfully residing children and pregnant adults. Refugees had been eligible for Medicaid for nearly half a century.

The Congressional Budget Office estimated the change would leave about 100,000 more people uninsured, while state data analysed by KFF Health News shows more than 281,000 people at risk in just nine states and the District of Columbia. Green card holders keep their coverage, and refugees can apply for one after a year in the country — but nearly 150,000 refugee green card applications are now pending with US Citizenship and Immigration Services, and processing times have more than doubled since the end of 2024.

Krish O’Mara Vignarajah, president and CEO of Global Refuge, warned that families will now “ration essential medication or put off care until a manageable problem becomes an emergency room visit,” and that a climate of fear around immigration enforcement is already leading some to forgo care altogether.

Sources:

• Global Refuge
• KFF Health News
• MedicalDaily