A change to US health law took effect on October 1, 2026. It narrows who can get federally funded Medicaid and the Children's Health Insurance Program (CHIP). Nepalis in the United States should check which immigration status they hold, because it now decides who can keep this coverage.
The change comes from H.R. 1, known as the One Big Beautiful Bill Act, which was signed in July 2025. Section 71109 of the law redefines who counts as a qualified noncitizen.
Who can still get coverage
Federally funded coverage is now mainly limited to:- US citizens and US nationals
- Lawful permanent residents (green card holders)
- Certain Cuban and Haitian entrants
- Migrants from the Compact of Free Association (COFA) countries: Micronesia. the Marshall Islands and Palau
State health departments, including those of Maryland and California, have confirmed these limits.
Who is affected:Many legal immigrants without a green card can no longer qualify. They include refugees, asylees, humanitarian parolees including many Afghanian and Ukrainian parolees, victims of trafficking, certain abused spouses and children and some survivors of domestic violence.
What stays in place:Emergency Medicaid is still available for emergencies, including childbirth. Pregnant people and children under 21 may keep some protection or other coverage,depending on their state's policy.
What is happening now: States began rechecking eligibility on October 1, 2026. They are closing or reducing cases of people who no longer qualify. Reports say thousands of legal immigrants have already lost health coverage.
Why the law changed: The law aims to cut more than $900 billion from Medicaid and SNAP through 2034. Narrowing immigrant eligibility is part of those savings.
What readers should do: Rules differ by state and by immigration category. Check with your state Medicaid office. Consult a licensed immigration attorney for your specific case.
