Proposed Changes to Demographic Data Collection in the Census Could Impact Efforts to Address Health and Health Care Disparities Authors: Drishti Pillai and Samantha Artiga Published: Sep 25, 2026

https://www.kff.org/racial-equity-and-health-policy/proposed-changes-to-demographic-data-collection-in-the-census-could-impact-efforts-to-address-health-and-health-care-disparities/?utm_campaign=KFF-Racial-Equity-Health-Policy&utm_medium=email&_hsenc=p2ANqtz--m--NZLzMWemOiEQI1ovzrrspPYi1aSNw5zcZ59QnBzF4ageE_uQpC0d9bGhYa_ZwRbmjBFjTm0Y8-lNunby4H_ajrvA&_hsmi=440966185&utm_content=440966185&utm_source=hs_email KFF Examines Proposed Changes to the U.S. Census That Could Decrease Federal Funding and Reduce Representation in Congress for States with Large Immigrant Populations A new KFF issue brief explains how major changes to the U.S. Census proposed by the Trump administration would negatively affect states with large immigrant populations and undermine research on racial and ethnic disparities in health and health care. Contact: Chris Lee | 202.654.1403 | ChrisL@kff.org The proposed Census changes would effectively prohibit the counting of many noncitizen immigrants, including undocumented immigrants and some lawfully present immigrants, and ban the inclusion of questions on race and ethnicity from the decennial census. The potential exclusion of millions of noncitizen immigrants from apportionment counts could lead to the reallocation of congressional seats and reduce political representation for states with large immigrant populations, such as California, Texas, and Florida. It also could lead to decreased federal Medicaid funding for such states, since the federal government’s share of most Medicaid expenditures is based in part on a formula that takes into account a state’s per capita income -- and the noncitizens who would no longer be counted are disproportionately likely to have lower incomes. That could mean higher state expenditures for states such as Florida and Texas. California is less likely to be affected in this way because the federal government already covers the lowest share of costs allowed under the formula (50%). Banning questions about race and ethnicity would eliminate a key source of data researchers use to understand population demographics and to ensure surveys are nationally representative. It would also limit the ability to examine trends over time, since the data will not be comparable to earlier versions