(Note: The message below covers expected changes after the signing of H.R. 1. For an update on the effects of H.R. 1 as of October 2026, please click here.)

Under current law, many lawfully present immigrants—including refugees, asylees, trafficking survivors, and other humanitarian newcomers—are considered "qualified non‑citizens".  As such, they are eligible for free medical care under Medicaid ("Medi-Cal" in California), the Children's Health Insurance Program (CHIP), Medicare for those over 65 or unable to work, or lower cost insurance premiums through the Affordable Care Act (ACA) healthcare marketplace. They also qualify for food stamps through the Supplemental Nutrition Assistance Program (SNAP), known as CalFresh in California. With H.R. 1, most of these lawfully present groups will lose eligibility for these programs, limiting immigrant recipients primarily to green card holders and a small subset of others.  

The change effectively bans thousands of documented newcomers from accessing essential care and support. Across the country, safety net access will be destabilized, uncompensated care will increase, and state insurance marketplace costs will rise, stripping away preventive services vital to healthy communities. Hunger and nutritional deficiencies will increase, in turn leading to greater demand for essential health care services. 

While some of these changes won’t take place for at least six months, there are immediate effects. States now have a financial incentive to dismantle programs that have delivered coverage to tens of thousands of residents with and without legal status, at great cost to public health and equity. California, for one, is already set to end new Medi-Cal enrollments beginning January 1, 2026 for immigrant adults over 19 who aren’t pregnant and don’t have legal status. 

States that have stepped forward to extend health care coverage either to undocumented or lawfully present immigrants face another blow: H.R. 1 cuts their federal Emergency Medicaid matching rate that reimburses hospitals for emergency medical services that they are required by law to provide, leaving states to carry the financial burdens.

As President and CEO of International Institute of Los Angeles (IILA)—which serves many newly arrived immigrant and refugee families—I've witnessed firsthand the health disparities and vulnerabilities that follow marginalization. Denying children, survivors of trauma, and resilient new Americans access to dependable healthcare doesn't just betray our values—it undermines public health and labor force participation. 

Families without insurance forego immunizations, prenatal care, mental health services, and basic diagnostics. Fear of deportation or losing aid discourages them from seeking care until crises escalate—by which point costs rise, outcomes worsen, and safety nets fray further. 

We cannot allow this law to unravel the fabric of support for those seeking refuge and a new start in our communities. It is not yet known how or if California will be able to cover those who categorically lose eligibility and for previously reimbursable emergency care. But we cannot wait for advocates and policymakers to start pushing back and finding ways to protect existing beneficiaries. Contact your California or respective state senators and assembly members, as well as your local officials, to declare your support for the right to healthcare for all residents. Urge them to start preparing today to counteract the destructive effects of H.R. 1. Then email or call your federal elected officials to reiterate as their constituent that you strongly disagree with these provisions of the bill.

H.R. 1 is not merely a fiscal adjustment—it’s a sweeping policy reversal that turns its back on vulnerable immigrant families and refugees. On behalf of those we serve in Los Angeles and across Southern California, I say this clearly: healthcare is a human right, not a privilege. We must stand together to defend access and dignity for all residents, regardless of immigration status. 

1. CONTACT YOUR STATE SENATORS AND ASSEMBLY MEMBERS / LOCAL OFFICIALS

Find your California or respective state representatives and local officials at Commoncause.org. Then call or email them with a personal message urging them to start preparing today to counteract the destructive effects of H.R. 1.

“My name is [insert name] and as your constituent from [City/Town] and a [person of faith/refugee/member of my community], I urge you and your staff to begin working today to do all you can to protect the immigrant community of [State] from the provisions of H.R.1 that will strip them of healthcare and food security. Healthcare and nutrition are basic human rights, regardless of immigration status. I support the use of state funds for these essential needs and ask you to take action today to protect them. Thank you.”

1. EMAIL YOUR FEDERAL REPRESENTATIVES

Go to https://democracy.io/#!/ and enter your address. After clicking submit, you will see your representatives listed. Choose all or only select representatives. Then click “Write to Them”. The next screen will be a form where you can enter your message. In addition to the suggested text below, be sure to add personalized comments.

“My name is [insert name] and as your constituent from [City/Town] and a [person of faith/refugee/member of my community], I am expressing my strong disagreement with the provisions of the “One Big Beautiful Bill Act” that strip essential food and health programs from immigrant communities and children.

Rather than putting vulnerable people at risk, Congress has a moral imperative to pass legislation that invests in nutrition, healthcare, education, housing, and safety for our communities, including people uprooted from their homes. My community stands with refugees, newcomers, and other marginalized communities – and I urge you to do the same so that everyone in our state can thrive.”

3. AMPLIFY ON SOCIAL MEDIA

Share this message with political leaders on social media! To find your legislator’s social media accounts, visit Commoncause.org and enter your address. Then narrow results by Federal, State, or Local officials and click on your desired platform to view their handles. Create posts and videos expressing your message and tag your officials’ accounts.