Trump's "Big Beautiful Bill" strips healthcare from legal immigrants

President Trump signed the One Big Beautiful Bill Act on July 4, 2025. The law requires Social Security numbers for healthcare benefits including Medicaid, CHIP, ACA subsidies, and Medicare.

The CBO estimates 11.8 million people will lose health coverage by 2034. Federal Medicaid spending drops by $6 billion over 10 years, with 100,000 more uninsured by 2034.

Starting October 1, 2026, only green card holders, certain Cuban and Haitian immigrants, and citizens of Freely Associated States can access Medicaid or CHIP. Other lawfully present immigrants lose coverage.

ACA premium tax credits for immigrants earning under 100% of the federal poverty level end by December 31, 2025. Credits for those earning above that level end by December 31, 2026.

The law makes 4.5 million children ineligible for the Child Tax Credit because one or both parents lack Social Security numbers. The vast majority of these children are U.S. citizens.

Medicare eligibility changes took effect immediately on July 4, 2025. Immigrants already enrolled can stay for 18 months, with full coverage ending January 27, 2027.

States must submit monthly enrollee Social Security numbers to a new federal verification system starting January 1, 2027. This system prevents dual enrollment across states.