Some immigrants may no longer qualify for Medicaid.
That’s due to changes that went into effect starting Thursday after the Reconciliation Law, also known as President Donald Trump’s Big Beautiful Bill Act, passed last year.
“Everyone's concerned. I think the biggest impact of this whole thing is that people are confused,” said Scott Darius, executive director of Florida Voices for Health, an organization that’s been working with families to make healthcare more accessible.
The new rules restrict Medicaid and the Children's Health Insurance Program (also known as CHIP) to what’s known as lawful permanent residents or “green card” holders. Also making the cut are Cuban and Haitian entrants, people residing in the U.S. under Compacts of Free Association (COFA), and lawfully residing children and pregnant immigrants.
However, those who do not qualify for Medicaid and CHIP include asylees, refugees, and humanitarian parolees like survivors of domestic violence or trafficking.
The new eligibility restrictions in Medicaid or CHIP are estimated to reduce federal spending by$6.2 billion and lead to an additional100,000 individuals becoming uninsured by 2034, according to the Congressional Budget Office.
States were tasked with determining the eligibility of their immigrants. In Florida, that job was given to the Florida Department of Children and Families, which oversees Medicaid beneficiaries' eligibility.
Losing coverage
In August, Florida sent letters to non-citizen beneficiaries it could not verify, asking them for immigration information.
“To find out if you are eligible for Medicaid under the new federal law, you must respond to the notice you received by providing DCF with documentation verifying your immigration status,” DCF wrote on its website.
If someone didn’t respond to DCF’s request for information, their coverage ended Wednesday.
Central Florida Public Media asked DCF how many beneficiaries it expects to remove from coverage, but it has not yet responded.
According to its website, 193,000 refugees used federal services, including Medicaid, in Florida in 2025.
With the changes come a number of concerns, including whether or not the correct people are losing access to coverage, said Katie Roders Turner, the executive director of the Family Healthcare Foundation, an organization that helps families navigate Florida’s healthcare system. She says families are generally confused about what’s being asked of them – and that could be a problem.
“It is an opportunity for something to get missed. And so, even if someone is eligible, if for some reason they did not open a letter in time, or maybe they've moved, or they didn't receive a letter,” Roders Turner said.
A history of mistaken terminations
Mistaken terminations of Medicaid coverage are not new in Florida. In 2023, DCF was tasked with reviewing the Medicaid eligibility of all recipients during the Medicaid Unwinding event.
During the COVID-19 Public Health Emergency, states couldn’t remove anyone from Medicaid, but when the emergency was declared over in late 2022, Florida began removing beneficiaries whose incomes did not qualify them for Medicaid in 2023.
The problem? The state removed people who were eligible.
According to KFF, about 58% of Florida’s recipients were terminated for procedural reasons – a change in address, a change in phone number, computer glitches, or any other reason the state was unable to reach a recipient.
While there are differences in the 2023 Medicaid eligibility review versus this year’s, there are concerning similarities, Roders Turner said.
“It's definitely the confusion of people who are receiving the communications and the requests to move forward with an actionable item in order to maintain benefits. That is definitely similar and feels very familiar,” she said.
Something that surprised Roders Turner was a number of families that came to her team with concerns that their children were losing Medicaid coverage.
“We have identified a few cases where families have come to us and told us that they did see that their children would have their benefits terminated for Medicaid in particular at the end of September,” Roders Turner said.
By law, immigrant children are not supposed to lose coverage. However, several families received letters from DCF that suggested their kids were being removed from coverage.
According to DCF’s website:
“In Florida, under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), lawfully residing children ages 18 or under will continue to be eligible for Medicaid.”
Central Florida Public Media reached out to DCF about those families. The agency stated it was looking into the matter.
The Chilling Effect
Aside from mistakes, another concern experts have is “the chilling effect,” or the idea of retreating from using healthcare services after receiving a letter to verify immigration status.
Darius said he’s spoken to lawfully present immigrants who are afraid to use healthcare and be deported due to a miscommunication.
“The fear of stepping out is mostly keeping people away from the things that they need. I think the consequence of that is that people get sicker,” he said.
“If people actually need help, and they wait till the last minute to do it, that's a cost that we're all absorbing anyway.”
Taxpayers end up footing the bill for that emergency room visit, which would’ve been cheaper if the person still had Medicaid, or could’ve been avoided altogether if that person wasn’t fearful of approaching preventative services earlier, Darius said.
“It's not a phenomenon without consequence to both the individual and the rest of us,” he said.
