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The 2025 reconciliation law includes new eligibility restrictions for many lawfully present immigrants for Medicaid and CHIP that become effective October 1, 2026. This brief provides an overview of implementation of the immigrant eligibility changes based on CMS guidance and issues to consider for affected individuals and states.
While the DHS guidance provides more details on public charge determinations under the new rule, it leaves key concepts unspecified and grants substantial discretion to individual immigration officers. This will likely result in ongoing confusion and fear among immigrant families that may deter them and their citizen children from participating in programs that help pay for health care, housing, or food even if they are eligible.
This brief provides an overview of health coverage of noncitizen children to provide greater insight into the potential role of Immigrant Children’s Health Improvement Act (ICHIA) coverage in limiting the 2025 reconciliation law's impact on coverage for lawfully present immigrant children.
If states do not provide coverage with state-only dollars and [gender-affirming] care cannot be financed in other ways, thousands of young people could be without a way to access what remains a recommended medical intervention.
Between 1.4 to 4.1 million Medicaid and CHIP enrollees living in a household with a noncitizen could disenroll due to public charge and other immigration-related fears.
The number and share of people without insurance grew in 2024, increasing for the first time since 2019, according to KFF's analysis of data from the American Community Survey (ACS). This issue brief describes trends in health coverage in 2024, examines the characteristics of the uninsured population , and summarizes the access and financial implications of not having coverage.
In February 2026, there were 345,000 fewer children enrolled in Medicaid/the Children's Health Insurance Program (CHIP) compared to before the start of the pandemic in February 2020, a 1% decline, according to the latest data from CMS.
Noncitizen immigrants, particularly those who are undocumented, face significant barriers to accessing health coverage and care and are significantly more likely than citizens to be uninsured. This brief provides an overview of state health coverage programs for immigrants, including among states that have taken up options in Medicaid and the Children’s Health Insurance Program (CHIP) to expand coverage for lawfully present immigrants and/or established fully state-funded programs to fill gaps in coverage for immigrants.
This brief provides key data on socioeconomic characteristics and health coverage among children (aged 18 and under) of immigrants based on KFF analysis of 2024 American Community Survey data. It also examines potential implications of recent policies and actions on the health and well-being of children in immigrant families drawing on KFF survey data from Fall 2025.
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