Trump’s Grand Scheme: Cutting Health Care for Legal Immigrants to Fund Tax Breaks

The U.S. Senate passed a new tax and spending bill early Tuesday, intensifying restrictions on healthcare and benefits for legally residing immigrants. This measure goes beyond the previously approved House version, which already penalized states for providing health care to certain immigrants.

The updated Senate bill seeks to further limit benefits for refugees and immigrants on humanitarian grounds, particularly affecting Afghans and Ukrainians who aided U.S. military efforts. Once promised a safe haven, these individuals now face a precarious future as benefits are stripped away.

Additionally, the bill reduces state reimbursements for emergency care in Medicaid-expanding states under the Affordable Care Act. This poses significant financial risks for those states, potentially forcing them to reduce services or withdraw from Medicaid expansion altogether, acutely impacting low-income citizens and newcomers alike.

The legislation cleared the Senate with three Republican dissenters: Sens. Rand Paul, Susan Collins, and Thom Tillis. With a tie-breaking vote from Vice President JD Vance, the bill now returns to the House for final approval before heading to President Donald Trump for his signature.

Healthcare advocates warn these cuts could exacerbate pressures on already overwhelmed hospitals and charities, especially in rural areas. These institutions are mandated to provide emergency care regardless of an individual’s ability to pay, potentially spiraling them into further financial distress.

Kate Woomer-Deters of the North Carolina Justice Center highlighted the dire situation for rural hospitals, indicating that refugees will still seek care despite losing coverage. Many groups, including Afghans and Ukrainians, face heightened challenges after risking their safety to assist U.S. operations abroad.

The legislation effectively eliminates Medicaid and food assistance for most refugees, with limited exceptions for a few immigrant categories. This includes individuals with green cards and some Cuba-based migrants awaiting citizenship. Many vulnerable populations, including survivors of domestic and sexual violence, stand to lose essential support systems.

With the new restrictions in place, Shelby Gonzales of the Center on Budget and Policy Priorities underscored the potential for increased emergency health care needs as uninsured individuals delay seeking care due to cost concerns. The cuts could significantly hinder not just immigrants but also lower-income Americans reliant on Medicaid.

In Indiana, where over 10,500 refugees arrived from 2013 to 2023, the new bill’s impact will be felt acutely. Afghan women, often facing barriers to employment due to language difficulties, depend on food assistance to make ends meet. Removing such safety nets could lead to dire consequences for these families.

Concerns about the bill were echoed by numerous stakeholders, who argue its design fails to recognize the contributions of immigrants to local communities and the broader economy. A recent Congressional Budget Office report predicts nearly 12 million people may lose health coverage under the new plan.

While some lawmakers tout potential savings for states, critics point out that these would come at the cost of millions losing access to necessary healthcare. This raises pressing questions about the long-term implications for public health and social welfare.

Leonardo Cuello from Georgetown University’s Center for Children and Families noted that the new Senate bill lacks adequate support for legal immigrants, characterizing it as a veiled attack on individuals who are legally present in the U.S.