Implementation of Medicaid Immigrant Eligibility Restrictions Under the 2025 Reconciliation Law: Issues to Consider Authors: Akash Pillai, Alisha Rao, and Samantha Artiga Published: Sep 22, 2026

https://www.kff.org/immigrant-health/implementation-of-medicaid-immigrant-eligibility-restrictions-under-the-2025-reconciliation-law-issues-to-consider/ The 2025 reconciliation law includes new eligibility restrictions for many lawfully present immigrants for federally-funded health programs, including Medicaid and the Children’s Health Insurance Program (CHIP), subsidized Affordable Care Act (ACA) Marketplace, and Medicare coverage. The eligibility restrictions for Medicaid and CHIP become effective October 1, 2026. These restrictions will eliminate eligibility for many groups of lawfully present immigrants, including refugees and asylees without a green card, among others. Under longstanding federal policy, undocumented immigrants already are ineligible for federally funded health coverage. The Congressional Budget Office (CBO) estimates that eligibility restrictions in Medicaid or CHIP will reduce federal spending by $6.2 billion and lead to an additional 100,000 individuals becoming uninsured by 2034.