New Medicare Eligibility Restrictions Impact Immigrant Communities
The federal budget bill signed into law on July 4th introduces significant changes to Medicare eligibility that will affect thousands of immigrant families across the United States. Under the new restrictions, Medicare coverage will be limited exclusively to U.S. citizens and a narrow set of immigrant groups.
Who Remains Eligible?
Under the new law, Medicare eligibility is now restricted to:
- U.S. Citizens
- Lawful permanent residents (green card holders),
- Certain Cuban and Haitian entrants, and
- People from the Marshall Islands, Micronesia, and Palau under Compact of Free Association agreements.
These are the same restrictions that will apply to Medicaid and subsidized ACA Marketplace health insurance (Pennie). Among those who will no longer have access to Medicare include refugees, asylees, human trafficking survivors, and survivors of domestic violence.
The new law represents a dramatic shift from longstanding Medicare policy. Previously, any lawfully present immigrant could qualify for Medicare by meeting one of two conditions: having sufficient work history (or their spouse having such history) or being a green card holder residing in the U.S. for at least five years.
Implementation Timeline
The restrictions on Medicare eligibility for immigrants will happen in two phases:
- Phase 1 – Starting July 4, 2025, all new Medicare applicants must meet the revised immigration status requirements. Individuals who don't fall into these eligible categories can no longer enroll in Medicare, regardless of their work history or tax contributions.
- Phase 2 – On January 1, 2027, all current Medicare beneficiaries who do not meet the immigration status requirements outlined above will be terminated from Medicare.
The new Medicare eligibility restrictions limit coverage to U.S. citizens, green card holders, and specific immigrant categories. Lawfully present immigrants who previously qualified through work history will lose access to Medicare, with changes affecting new enrollees immediately and current beneficiaries in January 2027. Many immigrants will now have limited healthcare coverage options due to existing and new related restrictions on Medicaid and ACA marketplace plans.
