Refugees Lose Medicaid Access Under One Big Beautiful Bill Act, NPR Reports

Refugees and asylum seekers across the United States are losing their Medicaid coverage starting October 1, 2025, following the passage of the federal budget legislation known as the One Big Beautiful Bill Act, NPR reported. The policy shift strips health benefits from the few immigrant groups that had previously qualified for the program, terminating access for individuals who arrived in the country seeking safety from conflict and persecution.

Mustafa Rfat, a professor of social work at the University of Nebraska at Omaha, said he has spent weeks fielding calls from families facing the loss of medical assistance. Mustafa Rfat noted that many are terrified by the reality that their children with disabilities are losing coverage.

Medicaid Losses Impacting Disabled Refugees

Refugees and asylum seekers who depend on state and federal healthcare assistance now face severe disruptions in managing chronic conditions and disabilities. Mustafa Rfat, who arrived as an Iraqi refugee in 2011 and utilized Medicaid to control a chronic inflammatory condition before becoming a U.S. citizen, described the program as an essential lifeline for acclimating to the country while dealing with wartime trauma and the loss of family members.

The Centers for Medicare and Medicaid Services stated that the agency is merely implementing rules set by Congress, though it did not respond to inquiries regarding the specific impact on refugees with disabilities. Drishti Pillai, director of immigrant health policy at KFF, explained that most individuals losing coverage under the new mandate will have no viable alternatives.

Drishti Pillai noted that while affected immigrants could theoretically purchase full-price coverage from Affordable Care Act marketplaces, those plans are often unaffordable. While employer-sponsored health insurance remains an option, many immigrants work in sectors such as construction, agriculture, and food service that do not offer such benefits, though a small number of states are working to establish independent coverage options.

Benefit Cuts Delay Preventative Care and Increase Future Costs

Ben D’Avanzo with the National Immigration Law Center explained that the immigrants losing healthcare and food benefits under the current cuts will eventually attain green card status and regain eligibility.

So these are people who are going to put off preventative care, who are not going to treat their chronic conditions, who are going to forego important medication.

Ben D’Avanzo

Ben D’Avanzo added that when these individuals eventually secure green cards and return to Medicaid, their overall health will likely have deteriorated significantly. That delay in care will ultimately drive up medical expenses for hospitals and government programs alike.