Legally residing refugees and asylees will face new challenges with accessing health insurance coverage. The 2025 budget law will cut Medicaid spending by about $1 trillion over 10 years, and Medicaid data usage by Immigration and Customs Enforcement is slated to resume.
KFF outlined four things to keep in mind:
1. Historically, a five-year waiting period is required for most immigrants to access federal public benefits. However, asylees and refugees meeting income and state-specific eligibility requirements are generally exempt. ACA coverage and Medicare have generally been available without a waiting period, too.
2. The 2025 budget law limits Medicaid, the Children’s Health Insurance Program, subsidized ACA Marketplace coverage and Medicare eligibility. Only green-card holders, some Cuban and Haitian newcomers, and U.S. residents who are citizens of the Pacific Freely Associated States are eligible.
3. States that have elected to cover Medicaid and CHIP for lawfully residing pregnant people and children can continue such programs.
4. Dates for changes vary by program. Medicaid and CHIP restrictions will take effect Oct. 1, 2026. Parameters for subsidized ACA coverage go into effect Jan. 1, 2027. Current Medicare beneficiaries will lose coverage no later than Jan. 4, 2027.
