Maria Ramirez Uribe, PolitiFact
“Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens.”
Vice President JD Vance in a Sept. 28, 2025, Fox News interview
As the U.S. headed for a authorities shutdown, Republicans repeatedly accused Democrats of forcing the closure as a result of they wish to give well being care entry to immigrants within the U.S. illegally.
“Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens,” Vice President JD Vance said Sept. 28 on “Fox News Sunday.”
President Donald Trump, House Speaker Mike Johnson, and Republican members of Congress have repeated this line.
It’s fallacious.
Democrats have refused to vote for Republicans’ decision to increase the federal spending deadline, and their place does, partially, hinge on well being care spending. Democrats wish to prolong covid pandemic-era Affordable Care Act subsidies which can be set to run out on the finish of the yr and roll again Medicaid cuts within the tax and spending invoice that Trump signed into legislation this summer time.
The Democrats’ proposal wouldn’t give well being care to immigrants who lack authorized standing; that inhabitants is already largely ineligible for federally funded well being care. Instead, the proposal would restore entry to sure well being care packages for legally current immigrants who will lose entry beneath the Republican legislation.
The White House didn’t reply to PolitiFact’s request for remark for this truth verify. Vance addressed criticism of his speaking level in one other interview by saying it was included within the Democrats’ spending proposal. It’s not.
A White House X account adopted up with screenshots of the Democratic proposal repealing a piece of the Republican legislation labeled “alien Medicaid eligibility.” It’s vital to know that these adjustments wouldn’t give Medicaid entry to immigrants who lack lawful standing.
Vance defended his assertion once more in an Oct. 1 White House press conference, saying former President Joe Biden “waived away illegal immigration status” that helped migrants entry federal help. It’s vital to notice that many individuals granted lawful status by means of humanitarian parole or Temporary Protected Status packages don’t routinely qualify for Medicaid; TPS recipients aren’t eligible, and many individuals who entered the U.S. on humanitarian parole are required to attend 5 years earlier than accessing it.
The Trump administration has ended humanitarian parole and Temporary Protected Status for many individuals, rendering them ineligible for Medicaid and well being plans on the Affordable Care Act market.
We didn’t discover proof that Democrats wish to spend “hundreds of billions” in prices for insuring migrants with illegal presence.
Immigrants Lacking Legal Status Are Already Ineligible
Most federal well being care {dollars} can’t be spent on well being take care of individuals within the U.S. who lack authorized standing. They can’t enroll in Medicaid or Medicare, and they’re ineligible to purchase health care coverage by means of the Affordable Care Act market. A small Medicaid program reimburses hospitals for uninsured emergency care, which might embody immigrants within the nation with out authorization however just isn’t unique to them.
States equivalent to California and Illinois expanded Medicaid coverage for individuals no matter their immigration standing, and the states pay for that. Federal legislation already banned states from utilizing federal cash for these packages. An earlier version of the Republican spending legislation would have penalized such states by withholding funding, however that provision didn’t final.
People within the nation with out permission would possibly obtain some federally funded well being care in emergency circumstances; in these conditions, hospitals should present care even when an individual is uninsured or within the nation illegally. Emergency Medicaid covers hospital take care of immigrants who can be eligible for Medicaid if not for his or her immigration standing. The Republican tax and spending legislation reduced the amount hospitals can obtain for emergency immigrant care.
Most Emergency Medicaid spending is used on childbirth. In all, it represented less than 1% of whole Medicaid spending in fiscal yr 2023, in line with KFF, a well being data nonprofit that features KFF Health News.
GOP Law Limited Care Access for Immigrants With Legal Status
The Republican tax and spending legislation made a number of adjustments to well being care eligibility for immigrants residing within the nation with permission. An estimated 1.4 million authorized immigrants are anticipated to lose their medical health insurance, in line with a KFF analysis of Congressional Budget Office projections.
Starting October 2026, the legislation will limit eligibility for Medicaid and the Children’s Health Insurance Program to lawfully everlasting residents, individuals from the Marshall Islands, Micronesia, or Palau who lawfully reside within the U.S. beneath an international agreement, and sure Cubans and Haitians.
Previously, a broad group, described as “qualified noncitizens,” was eligible for Medicaid and its associated Children’s Health Insurance Program, referred to as CHIP, together with refugees and other people granted asylum.
Some immigrants eligible for Medicaid and CHIP, equivalent to lawful everlasting residents, are required to wait five years earlier than accessing the advantages.
The legislation additionally restricted Affordable Care Act market eligibility to the identical group eligible for Medicaid and CHIP starting Jan. 1, 2027. Previously, individuals who had been described as “lawfully present” had been eligible. That group included the “qualified noncitizens” eligible for Medicaid and other people with short-term statuses, equivalent to Temporary Protected Status or worldwide college students.
Beneficiaries of the Deferred Action for Childhood Arrivals program, referred to as DACA, for immigrants who entered the U.S. with out authorization as youngsters had been beforehand eligible for Affordable Care Act protection and its subsidies. They are ineligible since a Trump administration rule took impact in August.
Democrats’ Proposal Would Restore Legal Immigrants’ Access
The Democrats’ Sept. 17 budget proposal would, partially, permanently extend the Affordable Care Act subsidies and roll again billions in Republican cuts to Medicaid and different well being packages.
The change would make Medicaid, CHIP, and Affordable Care Act protection accessible to all authorized immigrants who had been beforehand eligible for it, equivalent to refugees and other people granted asylum.
The Democratic proposal wouldn’t broaden eligibility to federally funded well being care packages to immigrants missing authorized standing.
Vance stated the Democratic insurance policies would “give hundreds of billions of dollars of health care benefits to illegal aliens,” and the White House didn’t provide its supply for that determine. When Johnson was pressed to support a similar talking point, he referenced the Congressional Budget Office. The KFF evaluation of CBO estimates discovered that the Republican legislation’s provisions associated to authorized immigrants would scale back federal spending by $131 billion; this projection didn’t embody an estimate for individuals with out authorized standing.
Our Ruling
Vance stated, “Democrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens.”
Immigrants within the U.S. illegally are largely ineligible for the federally funded well being care packages Medicare and Medicaid, they usually can’t search protection within the Affordable Care Act market or apply for subsidies.
The Democrats’ finances proposal wouldn’t change that.
The Democrats wish to restore entry to sure well being care packages to authorized immigrants who will lose entry beneath the Republican tax and spending legislation — amongst different measures geared toward making Medicaid and Affordable Care Act insurance coverage simpler to maintain.
Their proposal wouldn’t grant federally supported well being care advantages to individuals within the U.S. illegally, as a result of they didn’t have entry to them within the first place. The small quantity of funding designated for Emergency Medicaid reimburses hospitals that present emergency care to immigrants who can be eligible for Medicaid if not for his or her immigration standing. Finally, we didn’t discover proof for Vance’s assertion that Democrats need “hundreds of billions” in well being advantages for migrants within the nation illegally.
We charge the assertion False.
Our Sources
Fox News, “JD Vance Slams ‘Preposterous’ Claims on Comey Indictment: ‘Lied Under Oath’, Sept. 28, 2025.
The White House, “President Trump Delivers an Announcement,” Sept. 30, 2025.
President Donald Trump, Truth Social post, Sept. 29, 2025.
U.S. House of Representatives bill, accessed Oct. 1, 2025.
Congressional Budget Office, “Distributional Effects of Public Law 119-21,” Aug. 11, 2025.
PolitiFact, “Newsom Championed Medicaid for Immigrants in California Illegally. Now He Wants To Cut It Back,” May 16, 2025.
KFF, “Health Provisions in the 2025 Federal Budget Reconciliation Bill,” July 8, 2025.
KFF, “Potential Impacts of 2025 Budget Reconciliation on Health Coverage for Immigrant Families,” June 17, 2025.
KFF, “Key Facts on Health Coverage of Immigrants,” Jan. 15, 2025.
KFF, “1.4 Million Lawfully Present Immigrants Are Expected To Lose Health Coverage Due to the 2025 Tax and Budget Law,” Sept. 25, 2025.
U.S. Citizenship and Immigration Services, “Information for SAVE Users: Cuban-Haitian Entrants,” accessed Oct. 1, 2025.
U.S. Citizenship and Immigration Services, “Status of Citizens of the Freely Associated States of the Federated States of Micronesia and the Republic of the Marshall Islands Fact Sheet,” accessed Oct. 1, 2025.
Healthcare.gov, “Coverage for Lawfully Present Immigrants,” accessed Oct. 1, 2025.
Federal Register, “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability,” June 25, 2025.