US House Reconciliation Bill Would Strip Away Access to Health Care Coverage and Food Assistance for Many Florida Immigrants

‍*The U.S. House passed its reconciliation bill on May 22, 2025. The Senate is expected to pass its own version of reconciliation before the July 4 recess. This blog is focused on the provisions that are most likely to affect Floridians.*

Many people who call Florida home have moved here from other countries. Every Floridian, no matter where they come from or what they look like, deserves access to affordable health care coverage and other building blocks that help families thrive. Unfortunately, the Trump administration has pushed false and harmful rhetoric in an attempt to enact policies that would harm immigrants’ health and well-being. These policies have targeted asylum-seekers, migrants, refugees, and Deferred Action for Childhood Arrival (DACA) recipients who have lived and worked in the United States for most of their lives. Recently, the U.S. House of Representatives has followed suit in its reconciliation bill, proposing an elimination of health care access for certain immigrants. (See Table 1.)

As of 2023, Florida is home to nearly 5 million immigrants, making up 22.1 percent of its population. This is higher than the national share, as immigrants comprise 14.3 percent of the U.S. population. Over 75 percent of Florida immigrants have a documented status, and those without documentation contribute $1.8 billion annually to Florida’s economy through state and local taxes.

The House’s proposal would hit Miami-Dade County especially hard, which has 1.4 million immigrants, the highest share of any county in the United States. This represents more than half of Miami’s population; it is the only county in the nation where immigrants comprise over 50 percent of residents. In neighboring Broward County, 36.2 percent of residents are immigrants (or about 704,500 people)— the eighth-highest share nationally.

Proposed House Cuts

The U.S. House, as part of its plan to extend tax breaks skewed to the wealthy, has proposed deep cuts to health care, including eliminating access to various sources of coverage for certain immigrant populations. Those without a documented immigration status already do not qualify for Medicaid, Affordable Care Act (ACA) health insurance marketplace plans, or the Supplemental Nutrition Assistance Program (SNAP).

Specifically, the House reconciliation bill would:

‍Eliminate Supplemental Nutrition Assistance Program (SNAP) coverage for most lawfully-residing residents.^[1] The only people who would remain eligible are lawful permanent residents/green card holders, COFA migrants, and Cubans admitted under a family reunification parole program.

Eliminate access to Affordable Care Act (ACA) Marketplace Premium Tax Credits (PTCs) for most lawfully–residing residents.^[2] The only people who would remain eligible for PTCs are lawful permanent residents/green card holders, COFA migrants, and Cubans admitted under a family reunification parole program. This would increase the cost of health care coverage for Marketplace plans by eliminating subsidies that reduce monthly payments.

End ACA Marketplace Coverage for lawfully-residing immigrants who live below 100 percent of the Federal Poverty Level (FPL).^[3] Some lawfully-residing immigrants are ineligible for Medicaid due to their specific status. Currently, the federal government allows these individuals who would otherwise qualify for Medicaid to enroll in the ACA marketplace. Under the current proposal, certain immigrants with low income (under $15,650 for an individual) would no longer be eligible for the ACA Marketplace or Medicaid, denying them any pathway to health coverage.

‍End Medicare Coverage for lawfully-residing immigrants who have worked for at least 10 years in the United States and have earned their Medicare benefits.^[4] The only people who would remain eligible are lawful permanent residents/green card holders, COFA migrants, and Cubans admitted under a family reunification parole program.

End Affordable Care Act Marketplace eligibility for Deferred Action for Childhood Arrivals (DACA) recipients.^[5] These are lawfully present residents who have lived, worked, and paid taxes for virtually their entire lives in the United States. Many DACA recipients are students, entrepreneurs, employees, and small business owners.

End the requirement that states provide Medicaid and Children’s Health Insurance Program (CHIP) during a 90-day grace period to verify citizenship and/or eligible immigration status.^[6] At times, verification of citizenship or eligible immigration status can be delayed. Under this provision, if a state chooses to provide coverage during these 90 days, they would no longer be able to access federal matching funds to pay for it. This funding cut would burden Florida’s budget — which already faces a $3 to $7-billion deficit by FY 2027-28 — or lead to severe service cutbacks, including for young children and expectant women.

The House’s proposal would raise the price of health care coverage for Floridians across the board if passed by the Senate. In an attempt to provide tax cuts skewed to the wealthy, those who need relief the most will suffer. Florida cannot afford cuts to Medicaid, SNAP, or Marketplace coverage. The state’s representatives in Congress should advocate for the health and wellness of all Floridians, no matter where they come from.

Notes

^[1] H.R. 1, Section 10012, 119th Congress (2025-2026)

^[2] H.R. 1, Section 112101, 119th Congress (2025-2026)

^[3] H.R. 1, Section 112103, 119th Congress (2025-2026)

^[4] H.R. 1, Section 112104, 119th Congress (2025-2026)

^[5] H.R. 1, Section 44201, 119th Congress (2025-2026)

^[6] H.R. 1, Section 44110, 119th Congress (2025-2026)

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