WASHINGTON — With the government shut down, Republicans are centering their message on a simple argument: “Democrats are grinding America to a halt in order to give illegal immigrants free health care.”
That message, from a new ad from the National Republican Congressional Committee, has been echoed by GOP lawmakers and the Trump administration in recent days.
Vice President JD Vance claimed on Fox News that the GOP's “big beautiful bill” turned off health funding for “illegal aliens.”
“Democrats want to turn it back on,” he said. “It’s not something that we made up. It’s not a talking point. It is in the text of the bill that they initially gave to us to reopen the government.”
U.S. law already prohibits unauthorized immigrants from gaining any federally subsidized health care coverage — through Medicaid, the Affordable Care Act, the Children’s Health Insurance Program or otherwise. A 1996 statute established that.
House Minority Leader Hakeem Jeffries, D-N.Y., said Republicans are “lying” about the Democratic bill out of weakness.
“Nowhere have Democrats suggested that we're interested in changing federal law,” he said one day before the shutdown. “The question for the president is whether he's interested in protecting the health care of the American people.”
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The facts
The Republican claim is highly misleading.
The Democratic bill would not change existing law barring people who are in the U.S. illegally from getting federal health care coverage.
The dispute centers around immigrants whom the federal government has decreed as “lawfully present,” but who haven't formally been given legal status that is enforceable in court.
There are an estimated 1.4 million people considered “lawfully present” in the United States — including Deferred Action for Childhood Arrivals program beneficiaries, who came to the U.S. illegally as children; people who have Temporary Protected Status; and refugees and people seeking asylum who are still going through the legal process. Republicans are seeking to prohibit Medicaid or ACA eligibility for those groups.
They are not “undocumented” or “illegal” immigrants. The government knows who they are, and many are going through the process of seeking official legal status or green cards. Among other things, they are not unlawful border-crossers who have been flagged for deportation.
The GOP law prohibited those “lawfully present” immigrants from accessing federal health care programs. The Democratic bill would restore that access — but not for undocumented people who lack protected status — while also restoring the $1 trillion in Medicaid cuts, a core goal for Democrats.
The White House defended its claim by pointing to one portion of the “big beautiful bill” that Democrats are seeking to repeal, a section called “Alien Medicaid eligibility.” That section establishes the new limitations on health care access for lawfully present immigrants (“alien” is the federal term used to describe a noncitizen).
The White House also says the Biden administration abused the immigration parole program to grant temporary entry to the U.S. for people who shouldn't have received it. But if the Trump administration revoked that parole status, those individuals would lose their eligibility for any health care coverage under the Democratic proposal.
Another provision in the Democratic bill would extend subsidies that keep health insurance premiums low for people insured through the Affordable Care Act, which are set to expire later this year. Undocumented immigrants are already barred from accessing that money, and nothing in the Democrats’ bill changes that.
Vance also argued that the U.S. government should cut off payments for emergency care that is provided to unauthorized immigrants, which raises larger questions about health care policy.
“Very often somebody who’s there in the emergency room waiting is an illegal alien, very often a person who can’t even speak English," he said. "Why do those people get health care benefits at hospitals paid for by American citizens?"
The answer involves the 1986 Emergency Medical Treatment & Labor Act (EMTALA), which requires hospitals that take Medicare funding to provide emergency care for patients that come in — regardless of their immigration status, insurance or ability to pay. People who are rushed to the hospital with a life-threatening injury often need immediate stabilizing care, and the law prevents hospitals from waiting until they check that the patient is American, by which point he or she may be dead.
White House Press Secretary Karoline Leavitt sidestepped Thursday when asked if ERs should check immigration status before treating a dying patient.
“That’s probably not a question for me to answer. I think that’s a question for healthcare professionals and legal experts,” Leavitt said. “I don’t speak for emergency rooms across the country. I speak for the President of the United States.”
According to KFF, a nonpartisan research group, less than 1% of Medicaid outlays are spent on emergency care for non-citizens.
