Overview
- The federal eligibility change in HR1 took effect Oct. 1, 2026, and state agencies say it strips full Medicaid benefits from many lawfully present immigrants who do not hold green cards.
- Illinois estimates about 9,300 people will lose coverage, local groups put Pennsylvania’s total near 8,000, Minnesota expects roughly 5,000 people to be affected, and advocates in Iowa report at least 2,000 at risk.
- Those losing full Medicaid may still qualify for Emergency Medicaid for true emergencies, but that program does not cover routine care like primary visits, regular prescriptions or long‑term treatments.
- States and community groups are sending termination notices, opening helplines and advising appeals to maintain coverage during review, and some states with programs such as MinnesotaCare are moving people to limited alternatives.
- Providers and advocates warn of immediate harms — patients removed from transplant lists and gaps in dialysis and chronic care — while long USCIS green‑card backlogs make quick restoration unlikely and additional Medicaid changes are set to begin Jan. 1, 2027.