February 12, 2026
Washington, DC – The Center for Medicare Advocacy (CMA) and three other national advocacy organizations have taken new legal steps to demand transparency from the Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS) regarding the implementation of Medicare eligibility restrictions under H.R. 1 (the Budget Reconciliation Act of 2025). The agencies have yet to provide any guidance to the public – even as thousands of lawfully present immigrants face a total loss of health coverage – despite key provisions having taken effect on July 4, 2025.
The Issue
H.R. 1 enacted sweeping changes that strip Medicare eligibility from an estimated 100,000 lawfully present immigrants who have worked and paid Medicare taxes for years. While U.S. citizens and Lawful Permanent Residents (green card holders) remain eligible, the law excludes certain lawfully present immigrants, including:
- Individuals with Temporary Protected Status (TPS)
- Refugees and asylees
- Survivors of trafficking and domestic violence
- Individuals granted humanitarian parole
Despite the law taking effect on July 4, 2025, for new Medicare enrollees, SSA, which is responsible for Medicare eligibility and enrollment, and CMS still have not publicly updated their guidance or procedures.
The lack of federal guidance is particularly harmful right now. We are currently in the Medicare General Enrollment Period and the Medicare Advantage Open Enrollment Period, both of which run from January 1 through March 31, 2026. Without clear instructions from SSA or CMS, beneficiaries and the advocates who provide them guidance are left in the dark.
This results in confusion, fear and disruptions to benefits. Eligible individuals may forgo necessary medical care or fail to enroll because they are unsure of their status. The lack of transparency will likely lead to enrollment errors, coverage gaps, and potential late-enrollment penalties.
Medicare, to our knowledge, is the only federal benefit affected by H.R. 1 for which the administering agencies have failed to issue any public implementation guidance.
The Fight for Information
The Center for Medicare Advocacy, along with Justice in Aging, the National Immigration Law Center, and Refugee Council USA, filed a Freedom of Information Act (FOIA) request with SSA and CMS on September 15, 2025, seeking critical information regarding the implementation of H.R. 1. SSA finally responded on December 17, 2025, denying the request for expedited processing. CMS similarly responded on February 5, 2026, denying the request. Despite clear deadlines under FOIA requiring disclosure of information, neither agency has provided the coalition with any information or documents.
The organizations have now filed formal appeals with both agencies regarding their denials of expedited processing of their Freedom of Information Act (FOIA) requests.
The Center for Medicare Advocacy is working to reverse these harmful legislative changes and remains committed to ensuring that SSA and CMS are held accountable for their failure to provide basic information about drastic changes to Medicare eligibility and benefits to elderly immigrants who have paid into the system as taxpayers.
Contact: Matt Shepard, Communications Director, Center for Medicare Advocacy MShepard@MedicareAdvocacy.org or 202-293-5760.