Reconciliation Law Removes Medicare Eligibility From About 100,000 Lawfully Present Immigrants

The budget reconciliation law signed July 4, 2026, includes a provision that removes Medicare eligibility from an estimated 100,000 lawfully present immigrants who previously qualified for the program. Those affected include holders of temporary protected status, refugees, asylum seekers, survivors of domestic violence, survivors of human trafficking, and people with work visas.

KFF Health News reports this is the first time Congress has eliminated Medicare coverage from a category of legally residing individuals who had previously qualified for the program. The affected individuals, and their employers, remain required to pay Medicare payroll taxes even after losing eligibility.

The Congressional Budget Office estimated the provision will reduce federal Medicare spending by 5.1 billion dollars by 2034. Some states, including California, are exploring ways to provide alternative coverage for those who lose eligibility.

The law leaves unchanged Medicare eligibility for U.S. citizens and for lawful permanent residents who meet the existing five-year residency and work-history requirements. Advocates quoted in KFF Health News described the arrangement as a payroll-tax obligation without a corresponding benefit.