Trump’s ‘Big Beautiful’ law bars legal permanent residents, others from medical benefits
Vincentians and other Caribbean permanent residents (green card holders) could find themselves shut out of medical services in the United States (US) unless they meet certain conditions.
If the green card holder is a low-income person and has had green card status for less than five years, that person could find himself/herself unable to access Medicaid.
Medicaid is health insurance for people at the lower end of the economic ladder.
The ‘Big Beautiful Bill’, passed recently by the US Congress and signed into law on July 4 by President Donald Trump, bars Medicaid services to most non-citizens.
The bill amends Medicaid law to prohibit federal Medicaid payments for anyone who is not either: (a) a US citizen or (b) a qualified alien in a very limited set of categories.
The bill will also bar certain non-citizens from receiving subsidies to assist with paying for health insurance under the Affordable Care Act (ACA).
The amendment also ensures that if an immigrant is ineligible for Medicaid due to status, they cannot get ACA insurance subsidies either.
All aliens – including those with other lawful statuses (temporary protected status, asylum, student/work visas) or undocumented status – will no longer be eligible for full Medicaid after October 1, 2026.
The law does preserve two narrow exceptions – emergency medical services for undocumented (the pre-existing limited Medicaid), and the option for states to cover lawfully present children or pregnant women under the Children’s Health Insurance Program Reauthorization Act. However, aside from those, federal funding is cut off for any non-citizen not in the allowed groups.
Previously, a Vincentian who has had their green card for less than five years and with low income could get a subsidised plan on the ACA exchange, but this provision would block that.
