By Kirstin Snow
Health care is being stripped away to fund unprecedented tax cuts for the wealthy and yet, shamefully, Senator Chris Dush is touting the Republican megabill as a tax cut for working families.
The recently passed Republican megabill cuts health care for some of our neighbors, family members and friends — those of us with humanitarian protection, such as people granted asylum, refugees, certain victims of domestic violence or labor or sex trafficking, and people granted humanitarian parole. And yet recent statements from Senator Dush claim that it is only 1.4 million “illegals” who are about to lose their Medicaid coverage. This assertion significantly misrepresents the facts.
Since 1996, people without a documented immigration status, along with many people who lawfully live and work in the U.S., are not eligible for full Medicaid benefits. The 1996 Federal law restricts comprehensive Medicaid and Children’s Health Insurance Program (CHIP) coverage to U.S. citizens and a limited group of “qualified” immigrants (after completing an applicable five-year bar on benefits). But the recently passed reconciliation megabill restricts eligibility for health coverage even further, taking away federal funding for Medicaid and CHIP from states that continue covering “qualified” immigrants. It also severely narrows eligibility for Medicare and premium tax credits to help afford insurance on the Affordable Care Act marketplace, taking away access to affordable health coverage from most groups of lawfully present immigrants. By taking away health coverage from these groups, the country is turning away from its long history of supporting people fleeing violence and persecution.
What About “Able but Unwilling to Work”?
Senator Dush isn’t calling this cut to Medicaid a cut, despite almost 270,000 Pennsylvanians facing coverage loss due to burdensome work requirements. Not “meeting” a new requirement to report work hours is not the same as “refusing to work.”
Many of the affected are people facing barriers: health issues, caregiving responsibilities, lack of local jobs, jobs with seasonal or unstable hours, or insurmountable red tape in documenting their working hours or exemption status. Even those who are working risk losing coverage because the more frequently you force people to go through an application or reporting process, the more likely they are to be tripped up by paperwork, deadlines, and bureaucratic red tape. In fact, research shows that the large majority of those losing coverage will be people who are working or should qualify for an exemption based on criteria such as having a disability, being a parent, or attending school. Based on Arkansas’s experience with work requirements, it’s estimated that at least two in three enrollees losing coverage will be either workers or qualify for an exemption.
Blaming immigrants, and branding those who lose coverage as “lazy,” obscures the true impact of these cuts. The real casualties are children, working families, and neighbors — all of them Americans — who rely on affordable care. The bill does not magically redirect savings to “deserving” citizens. Instead, it increases the number of uninsured Americans and shifts costs onto local hospitals, taxpayers, and communities.
The claim that 1.4 million “illegals” and 4.8 million of “those who are able but unwilling to work” are losing Medicaid is false and misleading. Those targeted by the 1.4 million figure are not on Medicaid to begin with — and the broader Medicaid rollbacks will strip coverage from millions of Americans, many of whom are working, caregiving, facing health challenges, or rebuilding their lives after facing harm in their home country, not the “undeserving outsiders” some politicians portray.
Policymakers need to get serious about protecting Medicaid and supporting American families. The focus should be on policies that expand access and improve efficiency — not on scapegoating immigrants or demonizing those who struggle to find work. Let’s base our debates on facts, not fearmongering.
Kirstin Snow, PhD, is the director of communications at the Pennsylvania Policy Center. She previously served as the communications director for the Pennsylvania Budget and Policy Center and Keystone Research Center.