- Thousands of refugees and some other immigrants with legal status lost their health coverage on Oct. 1, marking some of the first significant coverage losses under the Medicaid cuts in the GOP’s One Big Beautiful Bill Act.
- Minnesota's Department of Human Services reported more than 5,000 immigrants in the state lost Medicaid coverage due to the federal rule change.
- Advocates say the eligibility restrictions will mean people lose access to doctors, as well as medications and treatments for diabetes and other chronic diseases.
- Officials express concerns about people not understanding the changes and the lack of resources to help, with one county official noting they can't cover costs for everyone unable to get Minnesota Care.
- The changes are part of the One Big Beautiful Bill Act, President Trump and congressional Republicans’ signature domestic policy legislation that he signed into law in 2025. The law is projected to cut Medicaid spending by $900 billion through 2034, largely by imposing new eligibility restrictions, work requirements and cost sharing.
- The nonpartisan Congressional Budget Office estimated that the Medicaid changes would lead to roughly 100,000 lawfully present immigrants losing health insurance.
- States and advocacy groups have been trying to warn immigrants who were previously eligible for Medicaid — such as refugees, asylees without a green card, survivors of domestic violence and victims of sex trafficking — that they no longer qualify.
Thousands of immigrants with legal status lost their Medicaid coverage on Oct. 1, following the implementation of the One Big Beautiful Bill Act, which is projected to cut Medicaid spending by $900 billion through 2034.1256
The new rules eliminate eligibility for immigrants over 21 who are not pregnant and do not yet have a green card. This change affects refugees, asylees, and other vulnerable groups, with Minnesota reporting over 5,000 individuals impacted.8
“This is a real shift that’s going to create a serious gap in access to healthcare services,” said Adriana Cadena, executive director of the Protecting Immigrant Families Coalition. Advocates warn that these restrictions will lead to increased uninsured emergency room visits and higher health system costs.
The nonpartisan Congressional Budget Office estimates that around 100,000 lawfully present immigrants will lose health insurance due to these changes, with the actual number potentially being much higher.7
A spokesperson from the Department of Human Services noted that about 75 percent of those affected may qualify for Minnesota Care, but this program lacks some essential services provided by Medicaid.
“The concern I have is that there are people who may not really understand what's happened,” said Eberhard, highlighting the confusion surrounding the changes.
As processing times for green card applications have ballooned to about three years, many immigrants face uncertainty regarding their healthcare coverage.
“We want to figure out how to get people the care they need,” said Edelson, emphasizing the challenges faced by local authorities in managing the fallout from these policy changes.
“Adriana Cadena of the Protecting Immigrant Families Coalition warned the shift will create a serious gap in healthcare access, especially for trauma survivors. Minnesota's DHS says about 75% of those impacted may qualify for Minnesota Care, but it lacks coverage for home and community-based services.”
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