President Trump‘s signature “One Big Beautiful Bill,” which passed the House Thursday, would slash Medicaid funding to 14 states and Washington, D.C., that use state dollars to provide health coverage to undocumented immigrants. The legislation reduces the federal match for states that expanded Medicaid under the Affordable Care Act from 90% to 80%—unless they roll back coverage for individuals without legal status.
According to KFF, this move would cost California up to $3 billion annually and New York $1.6 billion. Democratic leaders, including Gov. Gavin Newsom, warned the cuts would devastate health systems and threaten universal coverage goals.
States like Utah and Illinois face added pressure due to “trigger” laws that would end Medicaid expansion if federal funding drops. Critics say the provision is politically motivated and targets immigrant-friendly, Democratic-led states.
The Congressional Budget Office projects the bill would leave up to 14 million more people uninsured by 2034.
The legislation now moves to the Senate, where changes are likely but not guaranteed.
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