On October 1, 2026, a federal law called H.R. 1 changed which immigrants can get regular Medicaid. In Illinois, the state health agency, the Department of Healthcare and Family Services (HFS), estimates that about 9,300 people lost full Medicaid because of this change. For them, the last day of coverage was September 30, 2026.
HFS says the change is required by federal law and was not started by the State of Illinois. Many of the people affected are in the U.S. lawfully, such as refugees, asylees, and people with humanitarian parole. If you or someone in your family got a letter from HFS this summer, this article explains what it means and what you can still do.
Who lost full Medicaid
According to HFS, these groups are no longer eligible for federally funded Medicaid (unless they fit one of the exceptions in the next section):
- Refugees and asylees who do not yet have a green card
- Humanitarian parolees
- Survivors of domestic violence or human trafficking (in federally funded categories)
- Amerasian immigrants who have not adjusted to permanent resident status
- People granted withholding of removal
- Conditional entrants
- Victims of battery or extreme cruelty in the federally funded VAWA category (HFS says the state-funded program is not affected)
Who keeps coverage
HFS says these people can keep Medicaid after October 1, 2026:
- Naturalized U.S. citizens
- Green card holders (lawful permanent residents) who have completed the five-year waiting period, or who are exempt from it — for example, refugees, asylees, and trafficking survivors who later got a green card
- Certain Cuban and Haitian entrants
- COFA migrants (from the Marshall Islands, Micronesia, or Palau)
- Children under 19 (All Kids) and pregnant people (Moms & Babies) who live here lawfully; HFS says coverage during pregnancy and for 12 months after it ends is not affected
- People already enrolled in Health Benefits for Immigrant Seniors (HBIS), and people in Illinois-funded programs: AATV medical coverage, the medical program for survivors of domestic violence, and the kidney/renal disease program
Care you can still get
- Emergency Medicaid. It still pays for a serious medical emergency for people who meet all other Medicaid rules (such as income and Illinois residency) except immigration status. It does not cover regular doctor visits, prescriptions, or ongoing treatment.
- Community health centers and free clinics. Federally Qualified Health Centers (FQHCs) and free and charitable clinics serve people regardless of immigration status and ability to pay. Find one at illinoisfreeclinics.org or the IPHCA health center locator.
- Get Covered Illinois (the state Marketplace). People who lost Medicaid may be able to buy a Marketplace plan and may qualify for premium tax credits through December 31, 2026, according to state information reported by CBS News Chicago. HFS says that starting January 1, 2027, this group will no longer qualify for those tax credits, but lawfully present people can still buy a plan at full price. Call 1-866-311-1119.
Steps to take now
- Open every letter from HFS or IDHS. HFS says it mailed notices about these changes in July and August 2026 and planned another in September. Keep copies.
- Make sure the state has your current immigration status. If you recently got a green card, or you are pregnant, report it right away — you may still qualify. You can upload documents in ABE Manage My Case at abe.illinois.gov, visit your local IDHS office, or call the ABE Customer Call Center at 1-800-843-6154 (TTY 1-877-734-7429) or the All Kids Unit at 1-877-805-5312 (TTY 1-877-204-1012). HFS says that if your status cannot be verified right away, you get a 90-day period to send your most current immigration documents.
- Update your address, phone, and email at abe.illinois.gov so you do not miss future notices.
- If you think the state made a mistake, you can appeal. HFS says an appeal must be requested within 60 days of the decision; you can call 1-800-435-0774 or appeal through abe.illinois.gov. HFS also notes that a fair hearing may not be granted when the change happened only because the law changed, so an appeal is most useful if the status on file for you is wrong.
Also changing: Medicare
The same federal law limits Medicare for some noncitizens. HFS says that for new applicants on or after July 4, 2025, only green card holders, certain Cuban and Haitian entrants, and COFA migrants can qualify. People in other statuses who were already enrolled in Medicare as of July 4, 2025 can keep it until January 4, 2027, when it ends.
Where to get help
In its letter to affected families, HFS points people to the ICIRR hotline at 1-855-435-7693, where you can ask to be connected to an Immigrant Family Resource Program partner. For questions about your immigration case, contact the National Immigrant Justice Center at 312-660-1370. For questions about your Medicaid case, call the HFS Health Benefits Hotline at 1-877-805-5312.