Executive Summary
Many immigrants’ eligibility for Medicaid will be significantly restricted under the 2025 Budget Reconciliation Act (H.R. 1, also known as OBBBA). While H.R. 1 eliminated mandatory Medicaid funding for some individuals, it did not affect optional coverage for lawfully residing children and pregnant people pursuant to the Children’s Health Insurance Program Reauthorization Act (CHIPRA), nor the From-Conception-to-End-of-Pregnancy (FCEP) option. States may continue to receive federal funding to provide coverage to these populations, and take other actions to mitigate the harm of this devastating loss of coverage for immigrant communities. Our Top 10 suggestions for state advocates are offered in this guide.
