H.R. 1 Update: Thousands of Immigrants Lose Federally Funded Medicaid in PA
On October 1, thousands of immigrant adults in Pennsylvania – including refugees, asylees and certain humanitarian parolees – lost eligibility for federally funded Medicaid, also called Medical Assistance (MA) in Pennsylvania. The change is required by H.R.1, the federal budget law passed in 2025.
What does H.R.1 change?
H.R. 1 narrowed which non-pregnant immigrant adults can get federally funded MA. As of October 1, 2026, only three immigrant groups remain eligible, as long as they meet all other eligibility requirements:
- Lawful Permanent Residents (green card holders)
- Cuban and Haitian Entrants
- Compact of Free Association (COFA) migrants (citizens of the Pacific island nations of Micronesia, Marshall Islands and Palau)
Lawfully present immigrants who are under 21, pregnant, or within their 12 months of postpartum MA coverage are not affected and can keep their federally funded MA. There is a broad range of immigration statuses that are considered lawfully present.
What happens to people losing coverage?
State officials confirmed that the Pennsylvania Department of Human Services (DHS) mailed advance notices to the roughly 6,800 adults whose federally funded MA was ending.
Recent guidance and public comments from PA DHS clarifies the following related to immigrants losing coverage:
- Appeals: People who appealed the closure by October 1 will have their federally funded MA reinstated while the appeal is pending. The appeal counts as on time if it was postmarked or received by October 1. People who appeal after October 1 but before the deadline in the letter will not receive federally funded MA while the appeal is pending but may may have that coverage reinstated if they win. All appeals will be honored and scheduled for a hearing – this is true despite language in the notices suggesting some appeals would not be honored.
- SSI Recipients: People who receive SSI and lost federally funded MA will be transitioned into state-funded MA.
- Nursing facility care: State-funded MA can pay for nursing facility care (long term care) for people who qualify, including SSI recipients already living in a facility.
- Home and community-based services (HCBS): Immigrants who lost federally funded MA, including SSI recipients, will no longer receive federally funded HCBS waiver services, absent a successful appeal. DHS has taken the position that state-funded MA does not cover home and community-based services. However, people under age 60 may be eligible for Act 150, a state-funded program that provides attendant care (personal assistance) services. To apply for Act 150 contact the PA Independent Enrollment Broker (IEB) at (877) 550-4227 or fill out this application and submit it to the IEB.
For more info & help
On July 8, 2026, Community Legal Services and the Benefits Access Coalition presented a webinar called What You Need to Know About Immigrant Access to Medicaid The webinar recording and materials are available at the links below:
If you need help understanding your coverage options or filing an appeal, contact PHLP’s Helpline at 1-800-274-3248 or staff@phlp.org.