US Budget Talks: Democrats Extend Obamacare Subsidies, Not Free Healthcare for Illegal Immigrants

Before leaving the White House on Tuesday, President Donald Trump spoke to the press. Brendan Smialowski/AFP/Getty Images

As part of negotiations on the U.S. budget, Donald Trump and other Republican Party leaders accuse the Democrats of demanding free medical care for “illegal migrants” in exchange for backing funding for the federal bill.

Democrats want illegal migrants, many of whom are violent criminals, to receive free medical care.

“The Democrats are going to shut down the government because they demand funding for medical care for illegal migrants,” wrote Vice President J. Vans on X last week.

The Democrats are going to shut down the government because they demand funding for medical care for illegal migrants.

What really lies behind these statements

In fact, these claims are untrue. Democrats strive to preserve expanded federal subsidies to help Americans purchase Obamacare policies, but they do not intend to provide free medical care to illegal migrants.

The Democrats’ main goal is to extend the subsidies introduced as part of the Biden administration’s 2021 relief package, which ease costs of Obamacare. These subsidies will expire at the end of this year; according to KFF – an independent health research organization – without their continuation, the costs of Obamacare insurance policies in 2026 could rise by more than 75%.

The expanded subsidies have allowed many low-income citizens to obtain coverage with minimal or zero monthly premiums and broadened access to assistance for many in the middle class. This year a record number – about 24 million people – enrolled in coverage through the health insurance exchanges, of which about 92% receive subsidies.

Without more generous support, a significant portion of people are expected to leave the exchanges: according to the Congressional Budget Office (CBO), by 2034 about 4 million more people could be uninsured. Additionally, insurance companies are likely to raise Obamacare premiums due to the anticipated costs for those who remain on the exchanges.

It is worth noting that illegal migrants have never been eligible for Obamacare subsidies, and the One Big Beautiful Bill Act would restrict access for certain legally resident immigrants to the programs.

In addition to extending subsidies, Democrats are proposed to repeal historic health-care spending cuts – notably Medicaid – contained in the “big, beautiful bill.” The bill is expected to implement the first-ever work requirement in Medicaid and limit access for legal immigrants to the program, which could lead to about 10 million people becoming uninsured by 2034.

In a White House comment, officials emphasized efforts to roll back health-care cuts by Republicans, while noting that doing so would expand access to medical care for immigrants with legal status, but not for those who are illegal.

It is also known that illegal migrants are not entitled to federal health benefits, including Medicare, Medicaid, and CHIP. Medicaid may cover emergency medical care for illegal migrants, but it is not health insurance. According to KFF, in fiscal year 2023 less than 1% of total Medicaid expenditures went to emergency care for such migrants.

Some states cover children and part of low-income adults at their own expense. Previously, in one of Trump’s draft bills, there was a provision imposing penalties on states for such coverage, but it did not make it into the final version of the document.

The conclusion and current context indicate that the political discussion around the budget, health care, and immigration requires a clear understanding of the facts: the main mechanisms of health-care subsidies are aimed at supporting those who can afford a policy with government aid, and not at providing free medical care to those outside legal status.