In 2025, approximately 52 million immigrants lived in the United States, forming 16% of the population. Health insurance coverage is closely tied to immigration status – including Medicaid. Many groups of immigrants are categorically excluded from federally-funded health insurance programs. Undocumented immigrants, in particular, have long been prohibited from obtaining Medicaid. However, in the last year, inaccurate claims around Medicaid eligibility for immigrants have been used to justify policy changes proposed under the One Big Beautiful Bill Act (OBBBA). For example, one false claim was that undocumented immigrants were responsible for increased Medicaid spending. It is crucial to ground any discussions of policy proposals and their potential impacts in evidence.
Let’s first correct inaccurate rhetoric with evidence:
- Undocumented immigrants are not eligible for Medicaid coverage.
- Some lawfully present immigrants (i.e., green card holders, asylees, refugees) may have a “qualified” immigration status for Medicaid, but must wait five years before they are eligible for coverage.
- States have some discretion in eligibility policies for particular populations. In January 2025, 29 states and Washington, D.C. had expanded Medicaid coverage (and/or waived the five-year waiting period) for lawfully residing immigrant children and pregnant people.
- Emergency Medicaid covers limited emergency care if the individual would otherwise be Medicaid-eligible if not for their immigration status (e.g., a person is undocumented or legally present but still within the 5-year waiting period for Medicaid eligibility). This represents less than 1% of overall Medicaid spending, even in states with large undocumented immigrant populations.
- Compared to U.S.-born citizens, immigrants are more likely to be uninsured, use fewer health care services, and have lower per-capita health care expenditures.