One of the main lines of attack the White House and Republican lawmakers have leveled against Democrats amid the government shutdown is the claim that Democratic lawmakers want to give immigrants in the U.S. illegally free healthcare — which Democrats deny.
“Democrats are holding the American government HOSTAGE so they can give FREE health care to ILLEGAL ALIENS,” House Speaker Mike Johnson, a Republican from Louisiana, said on social media Wednesday.
Meanwhile, Vice President JD Vance accused Democrats of wanting to “take from the American people in order to give taxpayer-funded healthcare to illegal immigrants.”
Trump administration officials and Republican lawmakers have pointed to a provision in the Democrats’ funding proposal that would reverse the One Big Beautiful Bill Act’s measures narrowing Medicaid eligibility for noncitizens. The changes sought by Democrats would only extend Medicaid coverage to immigrants with some kind of legal status or government protection.
Before the bill passed earlier this year, U.S. law allowed several classes of immigrants living in the U.S. legally or with the government’s permission to apply for and get Medicaid, if they met other requirements.
Those groups included lawful permanent residents (also known as green card holders), Cubans and Haitians who entered the U.S. legally, people granted a humanitarian benefit known as “parole” to enter the country, refugees, immigrants who won asylum and others, including those who were issued deportation reprieves by a judge.
Some people in those groups may have crossed into the U.S. illegally but were later granted legal status, like asylum, or deportation deferrals by immigration judges.
The One Big Beautiful Bill Act — passed by lawmakers and signed by President Trump over the summer — significantly restricted noncitizen eligibility for Medicaid coverage, making it only accessible to lawful permanent residents, Cubans and Haitians who entered the U.S. legally and noncitizens from several Pacific islands.
The bill excluded those granted parole to enter the U.S., refugees, asylees and the other previously eligible immigrants. Roughly 1.4 million immigrants could lose health insurance coverage under the bill’s provisions, according to a KFF analysis of Congressional Budget Office data.
The Democrats’ funding proposal would restore noncitizen eligibility for Medicaid to the longstanding pre-2025 rules, reopening access for the classes of immigrants who were carved out earlier this year. All of those immigrants are in the U.S. either legally or with the government’s permission.
U.S. law has long rendered people living in the U.S. illegally — without any type of legal status — ineligible for most federal benefits, including Medicaid.
Trump administration officials, however, have argued that some of the lawfully present immigrants previously eligible for Medicaid were illegally let in by the Biden administration. They argue that in the case of those granted parole, the Biden administration waved them in using a “magic wand,” in violation of federal immigration law.
The groups of people granted parole under former President Biden — such as Venezuelans and Ukrainians — entered the country with the government’s permission and were authorized to work and live in the U.S. The Trump administration has suspended those Biden-era parole programs, and revoked the legal status of many of those who arrived under them.
The legal status of many of the other immigrants eligible for Medicaid before the “One Big Beautiful Bill” — like the refugees and asylees — is not disputed. Both refugees and asylees are on a path to permanent legal status and eventually, U.S. citizenship.
While people who are in the U.S. illegally are not covered by federal Medicaid, the program may reimburse hospitals providing emergency care to immigrants who lack legal status. Emergency funding for noncitizens constitutes less than 1% of total spending for the program, according to an analysis by KFF. The One Big Beautiful Bill Act lowered the amount hospitals can receive for these ER visits, which the Democrats’ government funding plan would reverse.
Democratic leaders have denied that they’re seeking to fund healthcare for immigrants living in the U.S. illegally. Most Democrats’ position is that they will not vote for a short-term funding extension that would allow the government to reopen unless Republicans extend Affordable Care Act tax credits that have helped millions of Americans lower their health insurance costs.
“Federal law prohibits the use of taxpayer dollars to provide medical coverage to undocumented individuals. And there is nothing in anything that we have proposed that is trying to change that law,” House Democratic Leader Hakeem Jeffries said Tuesday. “We are fighting for the healthcare of the American people.”
Some Republicans have also argued that if Democrats restore the federal Medicaid funding that was cut in the “One Big Beautiful Bill,” it would allow Democratic-led states to spend more state funds on health care for immigrants residing in the country unlawfully.
According to analysis by non-partisan health care researchers at KFF, more than a dozen states comprehensively cover care for low-income children who lack a legal immigration status using state funds. Some states, including California, provide some form of coverage to adults living in the country without authorization.
Republicans previously attempted to penalize these states in Mr. Trump’s budget bill, but that provision did not make it into the final legislation.
