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By Aliss Higham
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An estimated 32,000 people could lose their Medicare coverage in the coming months as the Social Security Administration (SSA) confirms it will begin applying new rules for the federal health insurance program this week.
In a November 10 notice to service providers, the SSA said the beneficiaries it contacts will be told their coverage may end February 1, 2027, unless they establish their immigration status within the time frame given in their notice.
The new rules, mandated in the One Big Beautiful Bill (OBBBA) legislative package that passed Congress in July 2025, narrow the pool of legal non-residents who can access Medicare. The bill removed refugees, people granted asylum, people with Temporary Protected Status and others from the list of permitted non-Americans allowed to enroll.
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Lawful permanent residents, Cuban-Haitian entrants and people lawfully residing in the U.S. under a Compact of Free Association can still enroll in Medicare. The new law does not impact U.S. citizens.
Medicare is a federal health insurance program for those aged 65 and older and younger Americans with certain health conditions or disabilities. More than 70 million people are enrolled nationwide.
The OBBBA made numerous changes to federal health and benefit programs for immigrants, narrowing eligibility for access to programs like Medicare, Medicaid, and the Supplemental Nutrition Assistance Program (SNAP).
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SSA Notices
The SSA has confirmed it is starting to send out notices to Medicare enrollees whose immigration status cannot be determined and who were enrolled prior to July 4, 2025. Those who do not confirm their status by the deadline provided on their notice may see their coverage end on February 1.
People may be asked to provide documents showing U.S. citizenship or an eligible immigration status, and SSA says they can upload evidence through their my Social Security account or bring it to a local office.
"Patients losing Medicare coverage may explore health insurance options through their own employer or that of their spouse, or they may visit their state’s Social Services office for potential programs and assistance," the Centers for Medicare and Medicaid Services said in a November 12 update. "Patients may also visit their local community health center that may offer low-cost health and dental care."
Retirement and disability payment rules remain unchanged.
32,000 Could Lose Coverage
The CMS has estimated the policy will cause around 32,000 people to lose their Medicare coverage.
The eligibility changes have sparked criticism from advocates for immigrants, the elderly and people with disabilities. The Medicare Rights Center has said the changes "will cause immense harm."
"Complicating, withholding, or revoking Medicare eligibility from older adults and people with disabilities who have followed the rules and paid into the program remains unconscionable," the nonprofit said.
A letter signed by 111 groups, including advocates for refugees, disabled and elderly Americans, urged the CMS to "prioritize early and clear communication, expand enrollment protections, and robust outreach as these strategies are imperative to mitigate the harm on impacted immigrants losing Medicare coverage, including those who are low-income older adults and people with disabilities."
"Those impacted range from people who gained Medicare only recently to people in their nineties who have relied on Medicare for decades," the letter reads. "They have lived and worked in the U.S. and paid Medicare taxes themselves or through a spouse, often for 10 years or more."
Newsweek has contacted the CMS for comment via email and is awaiting a response.
Trump's Changes To Federal Programs
Medicare is not the only federal program to undergo changes mandated by the OBBBA. The law similarly narrowed SNAP and Medicaid eligibility only to lawful permanent residents, Cuban-Haitian entrants and people covered by the Compacts of Free Association.
White House spokesperson Lauren Bis previously told The Associated Press that "immigrants must be able to support themselves without taking from overburdened benefits programs paid for by hard-working American taxpayers."
Broader work requirements have also been implemented across both programs. SNAP’s work requirements were expanded to adults through age 64 and parents whose youngest child is 14 or older, while removing exemptions for veterans, people experiencing homelessness and former foster youth. These are changes to the SNAP three-month time limit for certain able-bodied adults without dependents, not a universal new work requirement imposed on every SNAP recipient.
President Donald Trump has argued that too many people receive food assistance, telling Fox News in November 2025 that SNAP participation was "many times what it should be." The White House has also defended tighter work requirements as a way to reduce reliance on benefits and to preserve assistance for those who need it most.
For Medicaid, it introduced an 80-hour monthly work, education or community-service requirement for many adults ages 19 to 64 covered through Medicaid expansion, beginning January 1, 2027, with exemptions including certain parents and caregivers, pregnant women and certain people with qualifying health conditions.
Contact Newsweek editors on this story: Ben Kelly and James Debens
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