New federal restrictions implemented on October 1 have removed Medicaid coverage from certain categories of legal immigrants, including refugees and victims of human trafficking, as part of broader changes to the program under President Trump’s 2025 tax cut and policy law. The move is expected to lead to millions of people losing Medicaid coverage in the coming years, according to government projections.

The changes affect hundreds of thousands of immigrants who legally reside in the United States, many of whom work and pay taxes. Refugees, asylum seekers, and victims of human trafficking and domestic violence are among those impacted, while green-card holders remain eligible for Medicaid. The Congressional Budget Office estimates that broader Medicaid modifications introduced by the administration could reduce the number of insured individuals by approximately 7.5 million.

Advocates warn that losing Medicaid coverage may leave affected immigrants unable to afford private insurance, leading to deferred medical care or increased reliance on emergency services, which could strain healthcare systems further. Legal groups opposing the administration’s policies characterize the cuts as part of a broader effort to discourage immigrants from remaining in the country. Ben D’Avanzo, a senior strategist at the National Immigration Law Center, described the policy as a message to immigrants that they are unwelcome and should leave.

Affected individuals have begun to feel the impact. In Tucson, Arizona, María Chacon, who obtained a T visa as a victim of human trafficking, has cared for her son Jesus since he suffered a severe injury in a car accident that left him dependent on a ventilator and other life-sustaining medical supports. Medicaid previously covered nearly $25,000 per month in his care, including a caregiver stipend for Chacon and her husband. The family learned weeks before the October 1 cutoff that their coverage would end, raising concerns about how they will afford critical medications and services.

Chacon is appealing the decision with state Medicaid offices. Although she is in the process of obtaining a green card, she said Medicaid eligibility would not resume until five years after that status is granted, placing her son’s care in jeopardy. “Since that day I haven’t been able to sleep. We haven’t been able to eat or anything. We’re wondering what we’re going to do,” she said.

The White House defended the policy, with spokesperson Lauren Bis stating that immigrants must be able to sustain themselves without drawing on what she described as “overburdened” benefits funded by American taxpayers.

Observers from across the political spectrum see the move as part of a broader immigration strategy. Steven Camarota, research director at the Center for Immigration Studies, a think tank advocating for reduced immigration, said the October 1 cuts represent incremental efforts by the administration to limit immigration by screening for income potential and education, aiming to reduce reliance on public benefits.

Meanwhile, advocates emphasize the potentially severe human consequences of the policy. Chacon said her son’s medical condition prevents them from leaving the country, underscoring the practical dangers these changes could pose to vulnerable immigrant populations.

Medicaid, a jointly state- and federally funded program, has become a contentious issue during President Trump’s second term. The administration has emphasized rooting out fraud, including deferring over $1 billion in payments to California and Minnesota earlier this year, which critics argue targeted states led by Democrats. The new immigrant coverage restrictions now add to the ongoing political debates surrounding Medicaid’s future.