281,000 legal immigrants set to lose Medicaid as cuts begin
- Over 281,000 immigrants in nine states and D.C. face losing Medicaid in October.
- Florida alone identified nearly 177,000 immigrants who no longer qualify.
- The CBO expects about 100,000 more uninsured immigrants by 2034.
- California is spending $365 million to keep about 148,000 immigrants covered.
WASHINGTON, D.C., UNITED STATES — The first Medicaid cuts in President Donald Trump’s 2025 tax and spending law are landing on immigrants who are in the country legally, with more than 281,000 in nine states and the District of Columbia expected to lose coverage in October. State counts suggest the hit will be far larger than federal estimates had signaled.
State numbers outrun federal estimates
The Congressional Budget Office (CBO) had estimated the law’s eligibility changes would leave about 100,000 more immigrants uninsured by 2034, but states are reporting far bigger numbers for October alone, KFF Health News reported.
Florida accounts for most of them, with nearly 177,000 immigrants identified as no longer eligible, while Arizona, North Carolina, New Jersey and Washington state each expect thousands more.
Those losing coverage include refugees, asylees, victims of sex trafficking and interpreters who assisted U.S. service members in Afghanistan, all of whom are in the country with federal permission.
“None of them did anything wrong, and they are losing coverage,” said Colleen McCauley, policy and advocacy director at the Camden Coalition in New Jersey. Advocates say some states did not start sending notices until September, leaving enrollees little time to challenge a mistaken termination.
Final counts are not due until later this fall, but the early numbers already dwarf the federal projection.
More coverage losses are coming
For people like Ahin, a 25-year-old Syrian refugee in New Jersey whose intestinal surgery was covered by Medicaid, the change leaves no clear plan for the next hospital visit. “I’m really worried about this,” she told KFF Health News, which identified her by first name only.
“We’ve just been scrambling trying to find free medical care,” said Julianna Larsen, co-founder of the Arizona Refugee Center.
Medicaid is only the first step, as the CBO expects about 1 million immigrants to lose marketplace subsidies and about 100,000 to lose Medicare by 2034 under changes that start next year.
Some states are stepping in, with California spending $365 million to keep about 148,000 affected immigrants covered until July 2027, and New York and Pennsylvania offering state-funded coverage.
Elsewhere, immigrants who lose Medicaid are left with Emergency Medicaid, which covers emergency care but not regular doctor visits or prescriptions.
For hospitals and clinics, that points to more uninsured visits, more self-pay balances and more eligibility checks at registration. That shifts work onto revenue cycle management (RCM) teams, which will need to screen patients for other coverage, charity care and Emergency Medicaid before bills go out.
Providers adding that capacity through healthcare outsourcing can compare partners among the top U.S. healthcare outsourcing companies.
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- Trump cuts strip coverage from 450,000 New Yorkers · 7 Jul
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