Washington, DC – A coalition of national advocacy organizations has filed a Freedom of Information Act (FOIA) request with the Social Security Administration and the Centers for Medicare and Medicaid Services seeking records related to Medicare eligibility restrictions for noncitizens enacted under H.R. 1, the recently-passed budget reconciliation act. The request was filed by the Center for Medicare Advocacy, Justice in Aging, the National Immigration Law Center, and Refugee Council USA.
H.R.1 cruelly excludes an estimated 100,000 lawfully present immigrants from Medicare, regardless of how long they have worked and paid taxes with the promise of health coverage upon retirement or disability. Key provisions of the law took effect on July 4, 2025, immediately restricting Medicare eligibility for new enrollees. The advocacy organizations are requesting expedited processing of their FOIA request due to the urgent need for public transparency and concerns that the administration could cause further harm in implementing the law.
With Medicare’s annual open enrollment period approaching in October and thousands of current Medicare beneficiaries facing termination from the program in early 2027, advocates say clear guidance is needed to avoid confusion, fear, and unnecessary loss of health care.
H.R. 1 restricts Medicare eligibility solely to U.S. citizens, lawful permanent residents (green card holders), and certain narrow groups of other lawfully present immigrants.[1]
The law strips Medicare eligibility from all other lawfully present immigrants, including:
- Individuals granted Temporary Protected Status
- Refugees and asylum recipients
- Trafficking and domestic violence survivors
- Individuals granted humanitarian parole
Despite these changes taking effect in July 2025 for new Medicare enrollees, the Social Security Administration, which is responsible for Medicare eligibility and enrollment functions, has not yet updated its guidance or procedures.
“To our knowledge, it is unprecedented for Congress to eliminate Medicare categorically for people who have followed the law and paid into the program, sometimes for decades,” said Alice Bers, Litigation Director at the Center for Medicare Advocacy. “Transparency about how this devastating betrayal is being implemented is essential to protect immigrants to the greatest extent possible.”
The FOIA request seeks eight categories of records, including training materials and guidance provided to agency personnel, public-facing materials for beneficiaries, impact assessments, and records showing the number of individuals affected by the changes.
“We’re deeply concerned that the absence of clear guidance and procedures will harm immigrant communities, creating coverage gaps and unexpected financial liability when people seek health care,” said Natalie Kean, Director of Federal Health Advocacy at Justice in Aging. “Older immigrants are already facing coverage barriers from multiple fronts and are at serious risk of being uninsured entirely under H.R. 1. The absence of clear guidance amplifies the cruelty of stripping away Medicare from people who trusted the government’s promise of Medicare.”
The coalition noted that many affected individuals include refugees, people granted asylum, and survivors of trafficking and domestic violence.
“Refugees and other forcibly displaced people have already faced tremendous hardships and have particularly acute needs upon arrival,” said Meredith Owen Edwards, Senior Director of Policy and Advocacy at Refugee Council USA. “For 45 years, refugees have been eligible for Medicare—a critical lifeline for elderly refugees, those with disabilities, and medically complex cases who have experienced significant harm and protracted violence. Cutting off their access to Medicare benefits adds another layer of insecurity to people trying to rebuild their lives in safety.”
“H.R. 1 broke the federal government’s decades-long promise to lawfully present immigrants, that if they worked and paid their Medicare taxes, they would have health coverage when they retired or became disabled,” said Ben D’Avanzo, Senior Strategist, Health & Economic Justice Policy at the National Immigration Law Center. “The government must provide clear transparency for how it will implement these cruel new restrictions on immigrant taxpayers.”
Read the FOIA request.
Contact:
Matt Shepard, Communications Director, Center for Medicare Advocacy
MShepard@MedicareAdvocacy.org
202-293-5760
About the Organizations:
The Center for Medicare Advocacy is a national, nonprofit organization that advances access to comprehensive Medicare coverage and quality health care for older people and people with disabilities through legal analysis, education, and advocacy.
Justice in Aging is a national legal advocacy organization with the mission of improving the lives of low-income older adults by securing access to affordable health care, housing, and economic security.
The National Immigration Law Center defends and advances the rights and opportunities of low-income immigrants and their families, serving as one of the nation’s leading experts on immigrant eligibility for public benefits.
Refugee Council USA serves as the only national coalition devoted to forcibly displaced people in the United States, mobilizing expertise to protect rights and build welcoming societies.
[1] Certain immigrants from Cuba and Haiti and people from the Marshall Islands, Micronesia, and Palau residing in the U.S. under a Compact of Free Association (COFA migrants). See Justice in Aging, Older Immigrants and Medicare, Issue Brief, at 3 (Sept. 2025); National Immigration Law Center, The Anti-Immigrant Policies in Trump’s Final “Big Beautiful Bill,” Explained, at 6 (visited Sept. 14, 2025).