Today, October 1, 2026, roughly 600,000 foreign-born persons without a green card lose Medicaid coverage, and will rely from now on primarily for free care services such as in federally-funded community care centers and hospitals. This is a rough estimate, an extrapolation from a handful of state-specific estimates.  (I draw on here, here and elsewhere for this posting.)

The cutbacks would be much higher except that Cubans and Haitians who are covered by the legal statuses addressed are exempted. Due to the frustrating failure of the government to provide counts of persons accounted for by immigrant status,  I cannot estimate how many Cubans and Haitians avoid the cutbacks. It could be several hundred thousands.

In 2021, the Migration Policy Institute wrote that as of 2019, 9.5 million foreign-born persons (out of a total then of about 45 million) were in economic conditions associated with eligibility for Medicaid, but about half were ineligible, either because they were unauthorized or due to some previously established rule applying to immigrants. After the time of the report, millions of persons came to the U.S., many with conditional legal status.  If one takes these rough estimates into account, perhaps a million – couple of million foreign born persons in the country were as of September 30,2026 eligible for Medicaid – this is a crude guess.

Without knowing the specific conditions of legal presence one cannot say if a person – Afghan, Venezuelan,  etc. – is affected. It is almost as if the blow falls differently door by door.

Below is a summary of the major categories – not all – affected.

The refugees, people granted asylum, and humanitarian parolees losing Medicaid coverage beginning October 1, 2026, are people legally present in the United States who previously qualified for coverage but have not obtained green cards or another status that preserves eligibility. They generally have low incomes and meet their state’s other Medicaid requirements. Some will retain coverage through exceptions for children and pregnant people or through state-funded programs.

Refugees. Those still holding refugee status without permanent residency will lose ordinary federally funded Medicaid unless an exception applies.

People granted asylum.  They may already have lived here for years while their cases were considered. The affected group consists of people whose asylum has been granted but who have not yet become permanent residents. A pending asylum application alone generally did not establish eligibility for ordinary federal Medicaid.

Humanitarian parolees. Humanitarian parole itself provides temporary permission to remain, rather than permanent residency.