About 100,000 legally residing immigrants will lose Medicare coverage by January 4, according to a joint investigation by The Oaklandside, El Tímpano and KFF Health News. The cuts stem from the One Big Beautiful Bill Act signed by President Donald Trump last July, which bars several categories of legal immigrants from the program — including people who paid into the system for decades through payroll deductions.
Legal immigrants targeted
The law removed holders of Temporary Protected Status (TPS), refugees, asylum seekers, victims of domestic violence and human trafficking, and work visa holders from Medicare eligibility. All affected individuals have legal immigration status, according to the investigation.
Undocumented immigrants were already barred from Medicare and most federal social programs before the law’s passage.
Decades of contributions lost
Among those losing coverage is a 67-year-old Oakland educator and child development specialist who arrived from El Salvador in 1991 during the civil war. She worked with children and teenagers for more than 30 years, including overnight shifts caring for newborns and as a substitute teacher in Bay Area public schools.
Over 24 years, she contributed tens of thousands of dollars to Medicare and Social Security funds, according to her Social Security Administration earnings record reviewed by El Tímpano and KFF Health News journalists. After reducing to part-time work last year, she expected to receive Medicare and Social Security benefits — standard retirement benefits for American workers and legal immigrants who meet tenure and age requirements. Her coverage will now be canceled.
Political justification questioned
Republican lawmakers justified excluding immigrants from Medicare as necessary to reduce program costs. Two months after signing the law, Trump posted on Truth Social that Democrats wanted to provide free healthcare to undocumented immigrants, whom he described as including many criminals. However, the immigrant categories actually losing coverage have legal status in the country.
Neither the White House nor the Department of Health and Human Services responded to questions about whether it was fair to remove legal residents from a Medicare program they funded through payroll contributions.
Double threat for TPS holders
For TPS holders, losing Medicare represents only part of their vulnerability. If the Trump administration terminates Temporary Protected Status for El Salvador citizens — as attempted during his first presidential term — affected individuals would lose both insurance coverage and legal authorization to remain in the country, risking detention or deportation.
Congress passed the TPS program in 1990 under Republican President George H.W. Bush. It allows citizens of countries experiencing armed conflicts, wars and climate disasters to live and work in the United States when returning home would be dangerous. The Oakland resident received TPS in 2001 following two earthquakes in El Salvador that killed more than 1,100 people and displaced 1.3 million from their homes.
Bay Area impact
The Bay Area has a high concentration of immigrants with TPS and other forms of legal status. Many worked for decades, paid taxes and built careers in education, childcare and other sectors critical to the local economy. The loss of medical coverage for older adults in this group shifts costs to local emergency care systems and charitable clinics.
The Medicare exclusion takes effect January 4. Affected individuals must find alternative insurance options before that date, if any are available for their immigration categories.
Source: The Oaklandside