What you need to know
Over the last year, some members of Congress have expressed concerns that undocumented individuals in the U.S. are receiving taxpayer-funded health care. In this brief, we address these concerns:
- What lawmakers mean when they refer to individuals who are undocumented.
- When and how noncitizens can receive medical care in the U.S.
- Eligibility for federal health insurance coverage, including Medicaid and the ACA.
- How taxpayer programs fund (and do not fund) noncitizens' healthcare.
What do terms like “legal” and “undocumented” mean?
A lawfully present noncitizen is someone who has a Green Card (giving them permanent residency in the U.S. and work authorization), but also refugees, people granted asylum, people with work or student visas, people given Temporary Protected Status (TPS), and parolees (individuals whose refugee or asylum claims are being assessed). People who enter the country undetected or overstay visas are considered “undocumented,” or “illegal immigrants.”
What sorts of healthcare options are non-U.S. citizens eligible for in the U.S.?
Under current federal law, individuals holding Green Cards are eligible for Medicaid (the federal health care program for the poor and disabled) and Medicare (the federal health care program for seniors) after a five-year waiting period. Medicare eligibility also requires a 10-year work history in the U.S.
The One Big Beautiful Bill Act (OBBBA) of 2025 narrowed eligibility for other types of lawfully present noncitizens. Now, unless a noncitizen has a Green Card and satisfies the other requirements, they are excluded from Medicaid, Medicare, and Affordable Care Act premium tax credits.
For undocumented individuals, the only taxpayer-reimbursable medical care available is emergency treatment to prevent death, serious harm, or disability. This requirement comes from the Emergency Medical Treatment and Labor Act of 1986 (EMTALA), which requires hospitals to provide stabilizing care in such situations. They are also ineligible for Medicare, Medicaid, and the Affordable Care Act.
The OBBBA also changed how the federal government reimburses states for Emergency Medicaid, lowering the federal share of costs for emergency care provided to people without legal status in Medicaid expansion states, from the enhanced 90% match rate to each state’s standard rate. Emergency Medicaid is the program that funds EMTALA and accounts for about 0.4% of all federal Medicaid spending.
The Takeaway
Under current law, federal health care programs are not available to undocumented individuals, as well as non-citizens who do not have Green Cards. The exception is emergency care, but even in this case, care is limited to whatever is needed to stabilize patients.
For routine and elective medical care, the only noncitizens eligible for federal health programs are those with lawful permanent residence (Green Cards) who have lived in the U.S. for more than 5 years.
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Further reading
The Heritage Foundation. (2025, October 1). Yes, Senate Democrats have shut down the government over giving health care to illegal aliens. https://tinyurl.com/bdz2mpjh accessed: 11/11/2025
Rolling back the big beautiful bill’s health care provisions would not provide health care to undocumented immigrants. KFF. (2025, October 2). https://tinyurl.com/ymkpdywx accessed: 11/11/2025
Sources
Staman, J. A. (n.d.). Overview of the emergency medical treatment and active labor act (EMTALA) and emergency abortion services | congress.gov | library of Congress. https://tinyurl.com/nhzkve5a accessed: 11/11/2025
Rolling back the big beautiful bill’s health care provisions would not provide health care to undocumented immigrants. KFF. (2025, October 2). https://tinyurl.com/ymkpdywx accessed: 11/11/2025
Who Is Being Given Humanitarian Parole To Temporarily Enter the Country: Latest Data. TRAC Immigration. (2024, September 6). https://tinyurl.com/mr3p6vbw accessed: 11/11/2025
H.R.3734 - Personal Responsibility and Work Opportunity Reconciliation Act of 1996. congress.gov. (n.d.). https://tinyurl.com/43b6r3tb accessed: 11/11/2025
Contributors
Lindsey Cormack (Content Lead) is an Associate Professor of Political Science at Stevens Institute of Technology and the Director of the Diplomacy Lab. She received her PhD from New York University. Her research explores congressional communication, civic education, and electoral systems. Lindsey is the creator of DCInbox, a comprehensive digital archive of Congress-to-constituent e-newsletters, and the author of How to Raise a Citizen (And Why It’s Up to You to Do It) and Congress and U.S. Veterans: From the GI Bill to the VA Crisis. Her work has been featured in The New York Times, The Washington Post, Bloomberg Businessweek, Big Think, and more. With a drive for connecting academic insights to real-world challenges, she collaborates with schools, communities, and parent groups to enhance civic participation and understanding.
William Bianco (Research Director) is Professor of Political Science at Indiana University and Founding Director of the Indiana Political Analytics Workshop. He received his PhD from the University of Rochester. His teaching focuses on first-year students and the Introduction to American Government class, emphasizing quantitative literacy. He is the co-author of American Politics Today, an introductory textbook published by W. W. Norton, now in its 8th edition, and authored a second textbook, American Politics: Strategy and Choice. His research program is on American politics, including Trust: Representatives and Constituents and numerous articles. He was also the PI or Co-PI for seven National Science Foundation grants and a current grant from the Russell Sage Foundation on the sources of inequalities in federal COVID assistance programs. His op-eds have been published in The Washington Post, Indianapolis Star, Newsday, and other venues.
