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As of Oct. 1, refugees lose access to Medicaid across the country

SACHA PFEIFFER, HOST:

The first wave of Medicaid cuts from the Republicans' One Big Beautiful Bill Act takes effect today. Among those affected are the few groups of immigrants who had been eligible for Medicaid. As of October 1, they won't be anymore. That includes refugees and asylum seekers. NPR's Selena Simmons-Duffin has more.

SELENA SIMMONS-DUFFIN, BYLINE: Mustafa Rfat has lately been fielding frantic phone calls from refugees with disabilities.

MUSTAFA RFAT: I spent this past two weeks just talking with so many of them, terrorized by the reality that their children with disabilities are losing coverage.

SIMMONS-DUFFIN: Rfat is a professor of social work at the University of Nebraska at Omaha. When Rfat arrived as a refugee from Iraq in 2011, Medicaid was a lifeline, he says, as he got his own chronic inflammatory condition under control. He's now a U.S. citizen.

RFAT: I had to climb this big mountain of acclimating into the culture here, learning English, dealing with the traumas of the war, the loss of family members. I was determined, and Medicaid was the big factor that made my dreams come true.

SIMMONS-DUFFIN: Now he's trying to counsel refugees with disabilities facing the challenges of navigating life in the U.S. who won't have that. As of October 1, refugees and asylum seekers are among the groups that Medicaid will no longer cover. In a statement, the Centers for Medicare and Medicaid Services said it was implementing rules set by Congress and did not respond to NPR's follow-up question about the impact of that policy on refugees with disabilities. Drishti Pillai, director of immigrant health policy at KFF, says most of those losing Medicaid will have no other options.

DRISHTI PILLAI: They could still buy full-price coverage from ACA marketplaces, but that is often unaffordable. Employer-sponsored coverage is also an option, but many immigrants work in jobs that don't offer employer-sponsored coverage, such as jobs in construction, agriculture, food service.

SIMMONS-DUFFIN: She says a few states are creating their own coverage options for this group. Ben D'Avanzo is with the National Immigration Law Center. He says the immigrants being cut from health coverage and food benefits now will eventually become green card holders who are eligible.

BEN D'AVANZO: So these are people who are going to put off preventative care, who are not going to treat their chronic conditions, who are going to forego important medication.

SIMMONS-DUFFIN: Then when they do get their green card and get back on Medicaid, their health will be worse, which will be more expensive for hospitals and the government.

Selena Simmons-Duffin, NPR News, Washington.

(SOUNDBITE OF DIXSON SONG, "LA NOCTURNE") Transcript provided by NPR, Copyright NPR.

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Selena Simmons-Duffin
Selena Simmons-Duffin reports on health policy for NPR.