Thousands of Immigrants in PA and NJ to Lose Medicaid Next Fall as Eligibility Rules Change

Changes in Medicaid Eligibility for Immigrants

Starting in October 2026, tens of thousands of immigrants in Pennsylvania and New Jersey will lose their Medicaid coverage due to new eligibility rules. These changes are part of a broader policy that affects individuals who have legally immigrated to the United States but do not meet specific criteria outlined in the legislation. The impact will be particularly felt by refugees, victims of human trafficking, domestic violence survivors, and other vulnerable groups.

Currently, people with certain legal immigration statuses can qualify for Medicaid, which provides healthcare services to low-income families and individuals with disabilities. However, under the new rules, only legal permanent residents and immigrants from Cuba, Haiti, and specific Pacific Island nations will remain eligible. Others, including those granted asylum or temporary humanitarian parole, will no longer qualify for Medicaid coverage.

New Jersey’s Department of Human Services estimates that between 15,000 and 25,000 immigrants with legal status may lose their coverage. In Pennsylvania, the number could be as high as 150,000 noncitizen immigrants currently enrolled in Medicaid. State administrators will need to manually review each case to determine who remains eligible, often requiring them to examine detailed notes from initial enrollment.

Political Perspectives on the Policy

Republicans who supported the legislation argue that these changes ensure public resources are directed toward those most in need. They emphasize the importance of prioritizing funds for U.S. citizens and legal permanent residents. However, public health officials and advocacy groups disagree, stating that the move unfairly targets immigrants who have followed all necessary steps to enter the country legally.

Many of these individuals are on a path to permanent residency or citizenship and have been living in the United States for years, working full-time jobs and raising families. Removing their access to healthcare services could have serious consequences, especially for those who rely on programs like prenatal care.

Public Health Risks and Concerns

The Pennsylvania Department of Health has raised concerns about the “serious public health risk” posed by the loss of Medicaid coverage. Families who lose access to essential health services may face significant challenges, including reduced access to preventive care and emergency medical treatment.

Advocates worry that the Trump administration’s focus on deportations will create a “chilling effect” on healthcare access, even for immigrants who remain eligible for public programs. Colleen McCauley, policy and advocacy director at the Camden Coalition, highlights the fear among families who might avoid seeking medical care due to concerns about disclosing personal information that could lead to deportation.

State Responses and Future Steps

In response to these changes, state officials are urging current Medicaid enrollees to continue using their coverage while it is still available. Pennsylvania and New Jersey officials are collaborating with advocacy groups and community organizations to communicate updates as more information becomes available.

Pennsylvania officials are awaiting further guidance from the federal government on new rules that require some Medicaid recipients to report their work hours monthly and renew their coverage every six months. In New Jersey, stakeholders are exploring ways to minimize the number of people who could lose coverage. Much of the expected decline in Medicaid enrollment is anticipated to result from individuals struggling with the complex new reporting requirements rather than being ineligible due to insufficient work or other factors.

Potential Solutions and Policy Options

New Jersey is considering a buy-in program that would provide Medicaid-like coverage for individuals who cannot afford private health plans through the state’s Obamacare marketplace but are no longer eligible for Medicaid. Laura Waddell, health care program director for NJ Citizen Action, suggests this could help bridge the gap for those affected.

Lawmakers could also establish a health care cost transparency and affordability office to address rising healthcare costs. This initiative would aim to make healthcare more accessible and affordable for all residents, regardless of their immigration status.

As the implementation date approaches, both states are working to support affected communities and ensure they have access to the resources they need. The long-term impact of these changes on public health and immigrant populations remains a critical issue for policymakers and advocates alike.