Limits on affordable health care for immigrants

Northwest Justice Project

Reviewed for legal accuracy on 10/02/2026

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Learn how and when the Budget Reconciliation Act of 2025 (H.R. 1), formerly called The One Big Beautiful Bill Act), limits who can get Medicare, Medicaid, and Obamacare tax credits to only a few categories of immigrants, and when all other lawfully present immigrants will lose their insurance or credits, even if they’ve been working in the United States for years and paying taxes. 

1. Eligible immigrants

On July 4, 2025, Congress passed Budget Reconciliation Act of 2025 (H.R. 1, formerly called the One Big Beautiful Bill Act). The law limits Medicare, Medicaid, and premium tax credits to just 4 categories of immigrants:

  • Legal permanent residents (called green card holders)
  • Cubans and Haitian entrant
  • Citizens of Micronesia, the Marshall Islands, living in the U.S. under the Compacts of Free Association ("COFA migrants") 
  • Immigrants who have become U.S. citizens ( called naturalized citizens)

 

On September 30, 2026, a judge in a federal court case held that immigrants in Washington state who also get SSI can get Medicaid, for now. This isn't a permanent decision and could change, but in the meantime you can keep using your health insurance until you hear otherwise.  

2. Ineligible immigrants