Fact check: Trump falsely claims Democrats want to give free health care to ‘illegal aliens’ in government shutdown battle

By Tami Luhby, CNN

(CNN) — Amid government spending negotiations, President Donald Trump and other GOP leaders are accusing Democrats of demanding free health care for “illegal aliens” in return for their support of a federal funding bill.

“The Democrats want Illegal Aliens, many of them VIOLENT CRIMINALS, to receive FREE Healthcare,” Trump wrote in a Truth Social post last week.

“Democrats are about to shut down the government because they demand we fund healthcare for illegal aliens,” Vice President JD Vance posted on X last week.

But Trump and Vance’s assertions are not true. The Democrats are drawing a line in the sand over health care, but their demands aren’t centered on health care for undocumented immigrants.

The Democrats are pushing to continue more generous federal subsidies to help Americans afford Obamacare policies and to reverse deep cuts to Medicaid and other health coverage contained in Trump’s sweeping domestic policy agenda package. But neither of those changes would provide health coverage to undocumented immigrants, since they aren’t eligible for either program.

The Democrats’ top priority is extending the enhanced federal subsidies for Affordable Care Act coverage. The beefed-up assistance, which was enacted as part of the Biden administration’s Covid-19 rescue package in 2021, is set to expire at the end of this year. If it lapses, premiums for Obamacare policies in 2026 are expected to more than double, on average, according to updated estimates from KFF, a nonpartisan health policy research group.

Undocumented immigrants have never been eligible for Obamacare subsidies, and in fact, are barred from purchasing policies on the Affordable Care Act exchanges. The Republicans’ One Big Beautiful Bill Act narrowed the subsidy eligibility of certain immigrants with legal status, including refugees, asylees, survivors of trafficking and abuse with a pending or approved visa application and people with Temporary Protected Status, according to KFF.

In addition to renewing the enhanced Obamacare subsidies, the Democrats want to reverse the historic cuts to health care – particularly Medicaid – contained in the “big, beautiful bill.” The law institutes the first-ever work requirement in Medicaid and also restricts access of immigrants with legal status to the program, among other measures. These provisions are expected to lead to roughly 10 million more people being uninsured in 2034.

To support the case that Democrats want to give illegal immigrants free health care, House Speaker Mike Johnson pointed to page 57 of the Democrats’ bill to temporarily keep the government open. It calls for repealing the health provisions in a section of the One Big Beautiful Bill Act. Those include measures that limit access to Affordable Care Act subsidies, Medicaid and Medicare for certain immigrants who have been approved for some form of lawful status in the country.

Johnson and the White House on Thursday also used the term “non-citizen” to describe the Democrats’ proposal, which is an accurate description. But it’s misleading to call immigrants with a lawful status in the country “illegal aliens,” which is a description Johnson has also used, though the speaker argues some of these immigrants were improperly given this status by the Biden administration.

Asked for comment, a White House spokesperson pointed to the Democrats’ push to overturn the Republicans’ health care cuts.

On Thursday, Johnson added more details to his explanation of how illegal immigrants might benefit from Democrats’ proposal. He pointed to a provision in the One Big Beautiful Bill – which Democrats’ proposal would scrap — that he said prohibits Medicaid from paying more for “illegal aliens” emergency care than it does for children or disabled or elderly US patients.

Under longstanding federal law, hospitals are required to stabilize anyone who comes to them in an emergency, regardless of immigration status or ability to pay. Someone ultimately has to eat that cost.

Medicaid helps reimburse hospitals for providing emergency care for some immigrants with legal status not currently enrolled in Medicaid and for low-income undocumented immigrants, who are not eligible for Medicaid. But emergency Medicaid doesn’t provide undocumented immigrants with ongoing health insurance coverage for general care.

Less than 1% of total Medicaid spending went toward assisting providers through the emergency Medicaid program in fiscal year 2023, according to KFF. The “big, beautiful bill” reduces federal reimbursement for providers in certain states under the emergency Medicaid program but does not change eligibility or eliminate the program entirely.

Johnson also took aim at California and other blue states that provide health care to immigrants in the country illegally, asserting that the One Big Beautiful Bill closed a loophole surrounding that practice.

A number of states use their own funds to provide coverage to children and at least some low-income adults regardless of legal status. An earlier version of Trump’s agenda bill contained a provision that would have penalized these states, but it did not make it into the final legislation.

The “big, beautiful bill” did eliminate states’ ability to get a certain waiver related to the taxes that states can charge certain providers to help pay for Medicaid. The change reduces the federal funding the states can draw down. Republicans are arguing that states that provide their own coverage to undocumented residents, such as California, are shifting some of their federal matching funds to offset at least part of the cost of these state programs. But the “big, beautiful bill” provision is not directly tied to coverage for undocumented immigrants.

This article has been updated with new developments and information.

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