KFF graphic featuring a quote from Samantha Artiga, KFF vice president and director of the Racial Equity and Health Policy Program. It says, “These changes would significantly increase immigration officers’ discretion in making public charge decisions and could allow them to consider factors that had been excluded under the 2022 rule, including use of health, nutrition, and housing programs such as Medicaid, the Children’s Health Insurance Program, and the Supplemental Nutrition Assistance Program.”

⚡ KFF’s @sartiga.bsky.social explains that the proposed change to the public charge rule would likely lead to further declines in use of health care and programs among immigrant families. #QuickTake https://on.kff.org/445QwKs

Sharing of Medicaid enrollees’ information for purposes other than the provision of health coverage and care pose risks for individuals and may jeopardize confidence in the security of data held by agencies

Federal regulations also require states to publicize the confidential nature of information applicants and beneficiaries submit to them. Reflecting this requirement, many states have information on their websites specifying that data shared with Medicaid will be protected.

The Social Security Act and regulations require that the “the use or disclosure of information concerning applicants and beneficiaries” must be restricted to “purposes directly connected” with administering state health coverage programs.

What Privacy and Protection Standards are in Place for Medicaid Enrollees’ Personal Data?  | KFF This policy watch discusses the data privacy protections in Medicaid and the implications of breaches or violations of those protections.

As outlined in our @kff.org policy watch, federal and state laws and regulations provide protections designed to safeguard Medicaid applicant and enrollee data. These protections limit the use and sharing of personal information for administering the program.
www.kff.org/policy-watch...

The latest version of the penalty would apply to the 14 states & DC that cover undocumented immigrants with state funds. States that cover other lawfully residing groups through other pathways could be affected.

The final bill passed by the House limited the penalty to states covering immigrants who are not a “qualified alien” or lawfully residing “child or pregnant woman” covered under the Medicaid option.

KFF graphic featuring a quote from Samantha Artiga, KFF vice president and director of the Racial Equity and Health Policy Program. It says, “If states maintain their coverage, the federal Medicaid match penalty for expanding coverage to immigrants, including lawfully residing children and/or pregnant people, could shift $153 billion from the federal government to the 33 affected states and DC over the next 10 years.”

⚡ KFF’s @sartiga.bsky.social writes about how a small change in the reconciliation bill being considered by the House rules committee makes a big change in what’s at stake for health coverage of lawfully residing immigrant children and pregnant people. #QuickTake on.kff.org/43NYyH9

If states eliminate coverage to avoid the FMAP penalty more than 1.9 million people covered through state-funded programs for immigrants and additional lawfully residing children and pregnant people covered through the Medicaid/CHIP option could lose coverage with most likely becoming uninsured

Additionally, 9 of the 33 states that would be affected by the penalty have laws that automatically end expansion or require changes if the federal match rate drops, meaning the provision could result in funding and coverage losses for the entire ACA Medicaid expansion in these states

The federal Medicaid match penalty for expanding coverage to immigrants, including lawfully residing children and/or pregnant women, could shift $153 billion from the federal government to the 33 affected states and DC over the next 10 years

The revision expanded the penalty from 14 states & DC that cover undocumented immigrants with state funds to 33 states & DC that use a Medicaid/CHIP option to expand coverage for lawfully residing children and/or pregnant people

The reconciliation bill would penalize states that have expanded coverage to immigrants by reducing their federal Medicaid match rate for the ACA expansion group from 90% to 80%

Proposed Medicaid Federal Match Penalty for States that Have Expanded Coverage for Immigrants: State-by-State Estimates | KFF This analysis examines the potential impacts of a provision in the House reconciliation bill that proposes reducing the federal matching rate for the Affordable Care Act (ACA) Medicaid expansion popul...

A small language change in the version of the reconciliation bill that is being considered today made a big change in what's at stake for health coverage of lawfully residing children and pregnant people www.kff.org/medicaid/iss...

These provisions would likely increase the uninsured rate among immigrant families, including citizen children in those families, and have broader ramifications for the nation’s workforce and economy given the role immigrants play.

Proposed changes include:
*Medicaid FMAP penalty for states covering undocumented immigrants with their own funds
*Eliminating required Medicaid coverage for people while they are verifying immigration status
*Eliminating Marketplace and Medicare eligibility for many lawfully present immigrants

Potential Impacts of 2025 Budget Reconciliation on Health Coverage for Immigrant Families | KFF This policy watch discusses key provisions in the draft 2025 budget reconciliation legislation that are aimed at limiting health coverage for immigrant families.

New @kff.org overview of potential impacts of budget reconciliation on health coverage for immigrant families:
www.kff.org/policy-watch...

The proposal also raises questions related to the balance of power between the federal government and states and whether the federal government can condition federal Medicaid financing on state actions with their own funds

Federal savings would only be realized if states maintain their programs and have their federal match rate for the Medicaid expansion population reduced from 90% to 80%

If states eliminate their programs, there would likely be increased uninsured rates and barriers to care for immigrant families.

Which States Would Be Affected by a House Proposal to Cut Federal Medicaid Funding for States That Cover Undocumented Immigrants? KFF data show that as of April 2025, 14 states plus DC use state-only dollars to provide health coverage to children regardless of immigration status, including 7 states that also do so for at least s...

My new @kff.org quick take discusses the House's proposed penalty to reduce Medicaid financing for states covering undocumented immigrants with their own funds and identifies which states would be affected:
www.kff.org/quick-take/w...

14 states + DC use state-only funds to provide health coverage to children regardless of immigration status, with 7 states + DC also covering some adults

These programs fill gaps in coverage for immigrants who remain ineligible for federally-funded coverage

www.kff.org/racial-equit...

In @kff.org focus groups with Hispanic immigrants who are undocumented or living with an undocumented family member, some said they have become increasingly fearful of going to work and/or that they have noticed fewer workers showing up at their workplaces due to immigration-related fears

@kff.org Survey of Immigrants data show 1 in 5 lawfully present immigrants say they or a family member have limited participation in activities outside the home, including attending church, seeking medical care, or going to work, since January due to immigration concerns

Hispanic immigrants who are undocumented or living with an undocumented family member detail how immigration-related fears have taken a toll on their and their children's mental health and well-being in @kff.org focus groups

@kff.org Survey of Immigrants data show about 1 in 3 immigrants overall say they have experienced negative health repercussions due to worries about their own or a family member’s immigration status since January, rising to 4 in 10 lawfully present immigrants

@kff.org focus groups provide further insights into immigration-related fears experienced among Hispanic immigrants who are undocumented or living with an undocumented family member
www.kff.org/racial-equit...

KFF Survey of Immigrants: Views and Experiences in the Early Days of President Trump's Second Term | KFF The latest KFF Survey of Immigrants finds that immigrants’ worries about detention or deportation have risen sharply since 2023, even among lawfully present immigrants and naturalized citizens. This p...

The latest @kff.org Survey of Immigrants documents a sharp rise in worries about detention and deportation since 2023, even among lawfully present immigrants and citizens

6 in 10 lawfully present immigrants worry they or a family member could be detained or deported

www.kff.org/racial-equit...

New @kff.org survey and focus group reports document how the immigration policy landscape is affecting the daily lives, health, and well-being of immigrant families. These impacts may have long-term negative effects on health, including their children's health, and the nation’s economy and workforce

Elimination of Federal Diversity Initiatives: Implications for Racial Health Equity | KFF This brief explains the potential impacts of the elimination of diversity and disparities-related initiatives under the Trump administration on racial health disparities.

In implementing President Trump’s orders to eliminate DEI initiatives, the administration has taken broader action to eliminate priorities, actions, data, and funding related to diversity and disparities, which could widen racial health disparities: www.kff.org/racial-equit...

5 Key Facts About Immigrants and Medicaid | KFF Confusion persists about immigrants’ eligibility for federal programs, with about half or more of U.S. adults and immigrants adults saying they are unsure or incorrectly believe that most immigrants t...

Undocumented immigrants are not eligible for federally-funded health programs, including Medicaid, Medicare, and the ACA Marketplaces.

Immigrants pay more into the health care system than they use, helping to subsidize health care for U.S. born citizens.

www.kff.org/racial-equit...