Trump’s Budget Bill Threatens Medicaid in 14 Democratic States

WASHINGTON, D.C. — President Donald Trump’s new budget legislation threatens federal Medicaid funding for 14 states that offer health coverage to low-income immigrants living in the U.S. without authorization. Most of the impacted states are led by Democrats and provide insurance regardless of legal status.

The bill, referred to as the “One Big Beautiful Bill,” passed the House with narrow support on Thursday. It proposes to cut billions of dollars in federal Medicaid reimbursements unless the states reduce benefits for unauthorized immigrants. Advocates argue this policy is both compassionate and economically sound.

According to estimates by KFF Health News, approximately 1.9 million immigrants in these states currently receive coverage. California, which stands to lose the most funding—up to $3 billion annually—along with New York, which could face cuts of around $1.6 billion, has voiced strong opposition to the ongoing measure.

California State Senator Holly Mitchell criticized the legislation, stating, “California has made a decision to ensure universal health care for all. We need to stand our ground.”

Governor Gavin Newsom added that the bill would significantly harm California’s healthcare infrastructure, leading to millions losing their insurance and potentially closing hospitals. He indicated that the state may challenge the legislation legally.

The proposed cuts could lead to additional strain on states like Illinois and Utah, both of which have “trigger laws” that would terminate Medicaid coverage if federal funds decrease. Advocates like Utah Health Policy Project Director, and State Representative Brad Daw insist the cuts would lead to a public health crisis.

U.S. House Speaker Mike Johnson labeled state programs that cover unauthorized immigrants as “an open doormat” inviting illegal immigration. A recent Reuters-Ipsos poll shows mixed public approval for Trump’s immigration policies, which could further complicate political support for this bill.

If the Senate approves the bill, the states would have to find new funding sources, which could extensively impact their budgets starting in the 2027 fiscal year.