Thousands of lawfully present immigrant seniors in the United States are set to lose Medicare coverage despite having paid into the system for decades, following changes enacted under last year's Republican tax-and-spending law, as KFF Health News reports.
The policy, part of the "One Big Beautiful Bill Act" signed by President Donald Trump, removes eligibility for certain groups of immigrants, including temporary protected status holders, refugees and asylum-seekers. An estimated 100,000 people currently enrolled in Medicare will be affected, with disenrollments expected to take effect in early 2027.
Rosa María Carranza, a 67-year-old educator in Oakland, told KFF Health News that she's scared despite having contributed to Medicare and Social Security for more than two decades. "This is like a horror movie, a complete nightmare," Carranza said. "This is not how I imagined getting old."
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Carranza is part of a group of immigrants who are legally present in the U.S. and meet work requirements traditionally associated with Medicare eligibility. Under the new law, however, coverage is now largely restricted to U.S. citizens, lawful permanent residents and a limited set of other categories.
The change marks a significant shift in federal policy. "This is actually the first time that Congress has taken away Medicare from any group," said Drishti Pillai, director of immigrant health policy at KFF.
The Trump administration and Republican lawmakers have defended the measure as a way to reduce federal spending and limit benefits for noncitizens. Trump wrote on Truth Social back in September that Democrats "want Illegal Aliens, many of them VIOLENT CRIMINALS, to receive FREE Healthcare," adding, "We cannot let this happen!" The groups losing coverage, however, are in the U.S. legally.
The policy is currently facing legal scrutiny. The Center for Medicare Advocacy filed a lawsuit last week seeking details on how the government plans to implement the changes, arguing that federal agencies have not provided sufficient guidance. "Every day that passes without transparency increases the likelihood that eligible individuals will be deterred from enrolling," the complaint states.
The broader impact could extend beyond those currently enrolled. According to KFF, up to 1.4 million lawfully present immigrants could lose access to health coverage across multiple programs, including Medicaid and marketplace subsidies.
Health experts warn that removing coverage for older adults may lead to delayed care and more severe medical conditions. "It's quite easy for them to fall off the cliff," said Theresa Cheng, an emergency physician at Zuckerberg San Francisco General Hospital.
For Carranza, the uncertainty is immediate. After decades of work and contributions, she now faces the prospect of aging without reliable healthcare. "It's like getting slapped on the face after more than 30 years working for the system here," she said.
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