This fact sheet was co-authored by Natalie Kean, Director of Federal Health Advocacy at Justice in Aging, and Ben D’Avanzo, Senior Strategist, Health Advocacy at National Immigration Law Center.

Over 8 million older immigrant adults live in the United States. Over 1.6 million noncitizens are enrolled in Medicare.[1] The reconciliation legislation passed by the House of Representatives cuts health care for those who are lawfully present, authorized to work, and have lived in the U.S. and paid taxes for many years.

Breaking Medicare’s Promise

Under existing law, lawfully present immigrants are eligible for Medicare if they have the required work quarters and meet age or disability requirements. Immigrants are also required to pay taxes and, along with their employers, must pay the 2.9% Medicare tax to fund the program. In 2023, immigrants paid $58.7 billion into the Medicare trust fund.

The status quo reflects the promise of Medicare: if you work and pay your Medicare taxes, you will have health coverage when you retire or become disabled.

The House reconciliation bill rips up that promise. Medicare eligibility would be restricted almost exclusively to U.S. citizens, lawful permanent residents (green card holders), certain Cubans, and people residing under a Compact of Free Association. Any other immigrant would be excluded, no matter if they are lawfully present or how long they’ve worked.

This reconciliation bill sends a chilling message to all Americans: Congress is willing to take Medicare from people who pay into the program.

Multiplying the Harm by Slashing Medicaid and ACA

Those losing coverage from Medicare would be hurt by a provision removing eligibility for the same groups of lawfully present immigrants for Affordable Care Act (ACA) tax credits. Today, someone who is ineligible for Medicare can purchase ACA coverage instead, but these immigrants will be left without any affordable pathways to health care.

All older immigrants would also be hurt by all the Medicaid cuts, including the provision forcing states to stop covering immigrants with their own funds. Due to this provision, states would not be able to step up and provide health care for immigrants losing Medicare eligibility. If a state did, they would face a 10% cut to their Medicaid matching funds for the expansion population.

Leave Immigrants Alone!

Congress must reject these policies that undermine Medicare and leave older immigrants without any reasonable pathway to health care. To do otherwise will lead to disastrous consequences for all of us.

Endnote

  1. Weighted value derived from Justice in Aging’s cross-tabulation using data from the 2023, one-year American Community Survey (ACS) file. ↑