Lawfully present immigrant seniors, including those who have contributed to Medicare for decades, face disenrollment from the program due to recent legislative changes, raising concerns about their health and financial security.
Rosa María Carranza, a 67-year-old child development professional, is facing an uncertain future as lawfully present immigrants, including her, are set to lose their Medicare coverage. Carranza, who co-founded a Spanish immersion preschool in Oakland, California, has dedicated over three decades to caring for children and contributing to the community. However, recent legislative changes threaten her access to essential health care benefits that she has paid into for years.
On a sunny December morning, Carranza was helping a young girl navigate a rocky path in the forested hills of northeast Oakland. Her experience in the outdoors reflects her deep connection to nature, which she has fostered in her students. Yet, as she transitions to part-time work, she had anticipated relying on Medicare and Social Security benefits during her retirement. Unfortunately, due to the GOP’s One Big Beautiful Bill Act, signed by former President Donald Trump in July, Carranza and an estimated 100,000 other lawfully present immigrants will soon be barred from Medicare.
The legislation specifically targets various categories of immigrants, including those with temporary protected status, refugees, asylum-seekers, and victims of domestic violence and trafficking. As a result, those already enrolled in Medicare, like Carranza, will be disenrolled by January 4, 2024. This decision is part of a broader Republican strategy to reduce Medicare spending, arguing that taxpayer dollars should not fund health care for immigrants in the U.S. without authorization.
Despite their legal status, the disenrollment of these immigrants raises questions about fairness and equity in health care access. Neither the White House nor the Department of Health and Human Services has addressed concerns regarding the implications of removing legal residents from Medicare.
Immigrants without legal status have long been ineligible for Medicare and most federally funded public benefits. Carranza, who has lived in the U.S. since 1991, fears that losing her Medicare coverage could also jeopardize her legal residency status. The Trump administration previously sought to end temporary protected status for Salvadorans, which could lead to her deportation or detention.
Having left El Salvador during a civil war, Carranza initially overstayed her visa but later qualified for temporary protected status after natural disasters devastated her home country. This status has allowed her to live and work in the U.S., contributing significantly to the economy and community. However, the recent changes in Medicare eligibility threaten the peaceful retirement she envisioned after years of hard work.
Congress has narrowed Medicare eligibility to citizens, lawful permanent residents, and specific nationalities, effectively excluding many immigrants who have contributed to the system. This shift follows previous efforts to restrict access to Medicaid and other social support services for lawfully present immigrants. According to the Kaiser Family Foundation, approximately 1.4 million lawfully present immigrants are projected to lose health insurance due to these changes.
Health experts warn that the disenrollment of immigrant seniors from Medicare could lead to increased health risks. Delayed medical care can exacerbate existing health conditions, particularly for older adults who are already vulnerable to cardiovascular diseases. Emergency physician Theresa Cheng notes that seniors often face sudden health crises, and losing access to regular care could result in more severe health outcomes.
For Carranza, the stress of impending disenrollment has taken a toll on her mental health. She has begun seeking therapy to address her insomnia and anxiety, feeling as though she is “under constant attack.” The knowledge that she may lose her health insurance and legal status weighs heavily on her, especially as federal agents continue to detain immigrants across the country.
In California, where the largest population of immigrant seniors resides, state-sponsored insurance options have also been limited. Enrollment for adults with temporary protected status has been frozen, leaving many without alternatives. Governor Gavin Newsom’s recent budget proposal does not include provisions to offset federal health care cuts for lawfully present immigrants, citing significant fiscal pressures.
Despite these challenges, some state lawmakers are advocating for solutions to support immigrant seniors. Assembly member Mia Bonta is working on legislative measures to integrate those losing health coverage into Medi-Cal, California’s Medicaid program, emphasizing the need to ensure dignity and access to health care for long-time residents like Carranza.
Last year, Carranza experienced a glimpse of what losing her health coverage could mean when the Social Security Administration mistakenly informed her that she no longer qualified for retirement benefits. Although the error was eventually corrected with assistance from her congressional representative, the ordeal left her feeling vulnerable and anxious about her future.
As she reflects on her life and the contributions she has made to her community, Carranza holds a box filled with identification cards that document her journey in the U.S. “My life is in that box,” she says, encapsulating the uncertainty and fear that now accompany her as she faces potential disenrollment from Medicare and the loss of her legal status.
The implications of these legislative changes extend beyond Carranza’s individual situation, highlighting broader issues of health care access and equity for immigrant populations. As the landscape of health care continues to evolve, the experiences of individuals like Carranza serve as a poignant reminder of the need for inclusive policies that recognize the contributions of all residents.
This article was produced in collaboration with El Tímpano, a civic media organization serving and covering the Bay Area’s Latino and Mayan immigrant communities.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF, the independent source for health policy research, polling, and journalism.