The United States was heading towards a government shutdown, with Republicans repeatedly accusing Democrats of forcing this shutdown because they want undocumented immigrants in the country to have access to healthcare.
“The Democrats are threatening to shut down the entire government because they want to grant hundreds of billions of dollars in healthcare benefits to illegal immigrants,” said Vice President J.D. Vance on “Fox News Sunday” on September 28.
President Donald Trump, House Speaker Mike Johnson, and Republican members of Congress have echoed this sentiment time and time again.
However, this claim is false.
The Democrats have refused to vote in favor of the Republican resolution to extend the deadline for federal spending, and their stance is partly based on healthcare spending.
The Democrats aim to extend the subsidies of the Affordable Care Act (ACA) from the COVID era, which are set to expire at the end of the year, and reverse the Medicaid cuts included in the tax and spending law that Trump signed this summer.
The Democratic proposal would not provide healthcare to undocumented immigrants; this population is already largely ineligible for federally funded healthcare. Instead, the proposal would restore access to certain healthcare programs for immigrants with legal status who would lose access under the Republican law.
The White House did not respond to PolitiFact’s request for comments on this fact-check. Vance responded to the criticism of his argument in another interview, claiming that it was included in the Democratic spending proposal. However, it was not.
A White House X account continued the discussion by posting screenshots of the Democratic proposal that repeals a section of the Republican law called “eligibility of aliens for Medicaid.” It is important to note that these changes would not grant Medicaid access to undocumented immigrants.
Vance reiterated his statement in a press conference at the White House on October 1, claiming that former President Joe Biden “eliminated illegal immigration status,” making it easier for migrants to access federal assistance.
It is important to note that many individuals granted legal status through humanitarian permits or Temporary Protected Status (TPS) do not automatically qualify for Medicaid; TPS beneficiaries are not eligible, and many individuals entering the country with humanitarian permits must wait five years before accessing the program.
The Trump administration has revoked humanitarian permits and TPS for many individuals, making them ineligible for Medicaid and ACA marketplace health plans.
There is no evidence to suggest that Democrats want to spend hundreds of billions of dollars to provide healthcare insurance to undocumented immigrants.
Undocumented immigrants are already not eligible for most federal healthcare funding. They cannot enroll in Medicaid or Medicare, and they are not eligible to purchase health coverage through the ACA marketplaces.
A small Medicaid program reimburses hospitals for emergency care for uninsured individuals, which may include immigrants in the country without authorization, but it is not exclusive to them.
States like Illinois and California expanded Medicaid coverage to individuals regardless of their immigration status, with states covering the costs. The federal law already prohibited states from using federal funds for these programs. An earlier version of the Republican spending law would have penalized such states by withholding funds, but that provision did not persist.
Individuals in the country without authorization may receive federally funded healthcare in emergency cases; hospitals must provide care even if the individual is uninsured or undocumented. Emergency Medicaid covers hospital care for immigrants who would be eligible for Medicaid if not for their immigration status. The Republican tax and spending law reduced the amount hospitals can receive for providing this care.
Most Emergency Medicaid spending goes towards childbirth. In total, it represented less than 1% of total Medicaid spending in fiscal year 2023, according to KFF, a nonprofit health information organization that includes KFF Health News.
The Republican tax and spending law introduced several changes to healthcare eligibility for immigrants living in the country legally. An estimated 1.4 million legal immigrants will lose their health insurance under these changes, according to an analysis by KFF on Congressional Budget Office projections.
Starting in October 2026, the law will restrict Medicaid and Children’s Health Insurance Program (CHIP) eligibility to legal permanent residents, individuals from the Marshall Islands, Micronesia or Palau residing legally in the country under an international agreement, and certain Cubans and Haitians.
Previously, a broad group, defined as “non-qualified aliens,” met the requirements for Medicaid and CHIP, including refugees and individuals granted asylum.
Some immigrants eligible for Medicaid and CHIP, such as legal permanent residents, must wait five years before accessing benefits.
The law also limited eligibility for ACA marketplace insurance to the same group eligible for Medicaid and CHIP starting January 1, 2027. Previously, individuals described as “lawfully present” were eligible. This group included “non-qualified aliens” eligible for Medicaid and individuals with short-term status, such as TPS or international students.
Beneficiaries of the Deferred Action for Childhood Arrivals (DACA) program, for immigrants who arrived in the country as children without authorization, previously met the requirements for ACA coverage and subsidies. However, they are no longer eligible since a Trump administration rule went into effect in August.
The Democratic budget proposal, presented on September 17, would partially and permanently extend ACA subsidies and reverse billions of dollars in Republican cuts to Medicaid and other health programs.
The change would make Medicaid, CHIP, and ACA coverage available to all legal immigrants who were previously eligible, such as refugees and individuals granted asylum.
The Democratic proposal would not expand eligibility to federally funded healthcare programs for undocumented immigrants.
Vance claimed that Democratic policies would grant hundreds of billions of dollars in healthcare benefits to undocumented immigrants, but the White House did not provide the source of that figure. When Johnson was pressed to support a similar argument, he cited the Congressional Budget Office (CBO).
KFF’s analysis of CBO estimates found that the Republican law’s provisions related to legal immigrants would reduce federal spending by $131 billion; this projection did not include an estimate for undocumented individuals.
In conclusion, Vance’s statement that “Democrats are threatening to shut down the entire government because they want to grant hundreds of billions of dollars in healthcare benefits to undocumented immigrants” is false.
Undocumented immigrants are largely ineligible for federally funded healthcare programs, such as Medicare and Medicaid, and cannot access coverage through the ACA marketplace or apply for subsidies.
The Democratic budget proposal aims to restore access to certain healthcare programs for legal immigrants who would lose access under the Republican tax and spending law, among other measures to facilitate the preservation of Medicaid and ACA insurance plans.
Their proposal would not provide federally funded healthcare benefits to individuals in the country without legal status because they did not have access to them in the first place.
The small amount of funding allocated for Emergency Medicaid reimburses hospitals providing emergency care to immigrants who would be eligible for Medicaid if not for their immigration status. Finally, there is no evidence to support Vance’s claim that Democrats want “hundreds of billions” in healthcare benefits for undocumented immigrants.
This claim is rated as false.
