A Syrian woman with stage 4 cancer and a 9-year-old boy with epilepsy from the Democratic Republic of the Congo are among thousands of Arizona refugees who were set on OCt. 1 to lose their Medicaid health coverage.
"Medicaid has enabled him to attend school. He experiences seizures that require emergency medical attention and his school has said if he doesn't have his seizure medication he can't attend school," Meheria Habibi, site director for the International Rescue Committee in Tucson, said of the 9-year-old boy.
"His family cannot afford to cover those medical costs out-of-pocket."
As of Sept. 18, officials with Arizona's Medicaid program had identified 20,658 asylees, refugees and immigrants in humanitarian groups who will lose their full coverage. Nearly 15,000 of those affected are eligible for Federal Emergency Services, which is a Medicaid program that pays for emergency medical care, including labor and delivery, but not for routine, preventive or long-term care for chronic conditions. Another 5,744 of the affected immigrants were to lose their coverage altogether, according to an emailed statement from the agency's communications office.
People are also reading…
Arizona's $23 billion Medicaid program is called the Arizona Health Care Cost Containment System or AHCCCS, pronounced "access." As of Sept.1, AHCCCS provided health coverage to 1.8 million Arizonans. About 73 million Americans are enrolled in Medicaid. Approximately two-thirds of AHCCCS funding comes from the federal government.
Magdalene Munezero is a cultural health navigator at Valleywise Health, which has a Phoenix clinic that serves about 1,400 refugees, some of whom lost their Medicaid coverage Oct. 1 due to the One Big Beautiful Bill Act.
The out-of-pocket costs that Habibi's immigrant clients at the International Rescue Committee in Southern Arizona are facing without Medicaid are too large for families to pay on their own, and the scope of need exceeds community financial resources, too, she said. Her organization is reaching out to specialists who may be able to help with providing low-cost or no-cost health care to some of the affected immigrants.
The affected refugees are legal U.S. residents who got to Arizona through the U.S. Refugee Admissions Program.
They left their countries because of safety concerns, including violence, trafficking and persecution. Even though they are living legally in the United States, new federal restrictions mean that states no longer receive federal matching funds to provide them with Medicaid, which is a government health insurance program primarily for low-income people and people with disabilities.
New restrictions among several changes
Cubans, Haitians and Compact of Free Association immigrants (people from the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau) remain fully funded for Medicaid, as do refugees and asylees with lawful permanent resident status (green card), but other asylees, refugees, humanitarian parolees, victims of human trafficking, and certain abused spouses and children no longer qualify under the law's provisions.
There are about 30 lawful immigrant classifications in the United States, among them green card holders, people with student visas and refugees and about 11 of those classifications were eligible for Medicaid prior to Oct. 1, Leo Cuello, a research professor at Georgetown University's McCourt School of Public Policy, said during a Sept. 14 virtual news briefing.
"It's already somewhat of a strict test because there are 19 types of immigrants who are here lawfully but aren't eligible for full Medicaid," Cuello said. "And in addition to that you have the undocumented, who are also not eligible for full Medicaid."
The One Big Beautiful Bill Act signed by President Donald Trump further reduces the number of eligible classifications from 11 to three, Cuello said.
"It's a very strict cliff, so there will be a wave of October 1st terminations," Cuello said. "Bottom line, a lot of lawfully present immigrants are about to lose coverage, and many of them are in statuses where they have had very vulnerable journeys, escaping trafficking, war, domestic violence, and so it's really heartbreaking for them to lose this coverage."
Kicking legal immigrants off of Medicaid is the result of the Republican-backed budget reconciliation bill known as HR1 or the One Big Beautiful Bill Act, which proponents said will help strengthen the Medicaid program by cutting down on fraud and abuse and ensuring it reaches only the most vulnerable Americans.
Trump framed the One Big Beautiful Bill Act, signed into law July 4, 2025, as a way of removing migrants who lack legal documentation to stay in the country from Medicaid.
But undocumented migrants are not allowed to enroll in Medicaid in Arizona, and in other states where they are able to enroll, their care is paid for with state, not federal, money.
The new restrictions will hit Arizona refugees and asylees harder than their counterparts in most other states. That's because Arizona does not take advantage of the Immigrant Children's Health Improvement Act, which allows states to provide Medicaid coverage to lawfully residing immigrant children and pregnant women.
"We don't do it because we have lawmakers who are not compassionate," said Will Humble, a former state health director and now executive director of the Arizona Public Health Association. "They don't care. We could have been doing it for many years. But it's not something that any Arizona Legislature has wanted to do."
The Oct. 1 change is affecting some newly arrived refugees who were medically fragile when they arrived and need medical care in order to be well enough to work, said Joanne Morales, senior programs director for Catholic Charities in Phoenix.
"We have refugee survivors of torture, genocide and war. Some have behavioral health issues, PTSD (post traumatic stress disorder), gunshot wounds and other types of injuries," Morales said. "Refugees who are admitted lawfully are allowed to apply for a green card within one year. We have refugees who arrived within the last two to three years who have followed the procedures, but there are delays in (green card) processing."
Magdalene Munezero, a cultural health navigator at Valleywise Health, came to Arizona from Burundi 11 years ago and spent three years covered by AHCCCS before she got a job that gave her employer-sponsored coverage.
"When I first arrived here, I relied on AHCCCS. When I came, I suffered through asthma," she said. "Medicaid helped me a lot, including to have an inhaler."
'This impacts everyone seeking care in hospitals'
The Oct. 1 coverage losses are putting hospital emergency rooms at risk for higher patient volumes because when patients lack health insurance they are more likely to forego preventive care and seek help in emergency rooms when their condition reaches a perilous stage, said Ann-Marie Alameddin, president and chief executive officer of the Arizona Hospital and Healthcare Association.
"This impacts everyone seeking care in hospitals," she said. "It's a fraying of the safety net."
About 1,400 patients receive care at a clinic for refugees at Valleywise Health in Phoenix, and program officials have been working with clients affected by the Oct. 1 changes, Munezero said.
"Many of my patients are going to be very affected. They came here legally; it's not that they came illegally," Munezero said. "They have families, large families. There are households of 12, 14 and 16 who have been here since 2022 and they haven't received their green cards yet. They are going to lose their benefits."
Most of Munezero's patients are from Burundi, Rwanda and the Democratic Republic of the Congo, and many have spent most of their lives in refugee camps prior to coming to the United States. Upon arriving in Arizona, they are learning about an entirely new world, often seeing indoor plumbing, paved roads and abundant food for the first time.
Learning about the health coverage is causing anxiety and suicidal thoughts among some of her patients, Munezero said.
"Our management is not sleeping," she said. "If this care is going to be taken away, for some of them, it means death. It is really, really bad."
Valleywise, which is the public health system for Maricopa County, is telling its affected patients that it will continue to provide care to those who need it, Munezero said, but there is a lot of confusion.
Like other nonprofit organizations that work with refugees and asylees, Valleywise is encouraging legal immigrants who may lose their coverage to respond to correspondence from AHCCCS and, if necessary, provide the requested documentation.
The Oct. 1 cutoff date for certain legal immigrants to stop receiving Medicaid was the first wave of changes to the federal program under the budget reconciliation law that critics say will spike the number of Americans without health insurance. Other changes set to begin Jan. 1, 2027, are work requirements and twice-yearly renewals, up from once per year.
The state in September launched a new website — https://keepmyahcccs.com/ — to help people keep their coverage.
