U.S. plan to cut Medicaid for legal immigrants, including refugees and trafficking victims, takes effect Oct. 1

Hundreds of thousands of lawfully present immigrants could lose Medicaid coverage beginning Oct. 1, according to state data. The change is part of the One Big Beautiful Bill Act, a Republican effort to reduce Medicaid spending by more than $900 billion through 2034.

Groups at risk include refugees, asylees, victims of sex trafficking and interpreters who served U.S. forces in Afghanistan. These individuals currently have federal permission to reside in the United States and rely on Medicaid and Affordable Care Act subsidies for health care.

The legislation does not affect a few categories, such as green‑card holders, but it will also strip many immigrants of ACA plan subsidies and Medicare coverage next year.

The policy shift signals a broader impact of the 2025 Trump‑era health reforms, extending beyond the originally targeted low‑income U.S. citizens to a wider immigrant population.