Policy & oversight
Reconciliation Law Removes Medicare Eligibility From About 100,000 Lawfully Present Immigrants
A provision in the July 4 reconciliation law bars certain categories of legally residing noncitizens from Medicare, even as they continue to owe Medicare payroll taxes.
By the Goodsurance editorial teamJuly 11, 2026
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.
About 100,000 lawfully present immigrants lose Medicare eligibility under the new law, while still being required to pay Medicare taxes.
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.
In plain words
A law was signed on July 4, 2026. It takes away Medicare coverage from about 100,000 immigrants who live legally in the United States. The people affected include refugees, people with work visas, and others with legal status. These people still have to pay the Medicare tax from their paychecks, even though they can no longer use Medicare. This has never happened before. The government expects to save about 5.1 billion dollars by 2034 from this change. Some states are looking at ways to help the people who lose coverage.
Understand the basics first
Source: KFF Health News
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