\u201cDemocrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens.\u201d<\/p>\n
Vice President JD Vance in a Sept. 28, 2025, Fox News interview<\/p>\n
As the U.S. headed for a government shutdown, Republicans repeatedly accused Democrats of forcing the closure because they want to give health care access to immigrants in the U.S. illegally.<\/p>\n
\u201cDemocrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens,\u201d Vice President JD Vance\u00a0said\u00a0Sept. 28<\/a> on \u201cFox News Sunday.\u201d<\/p>\n President\u00a0Donald Trump,<\/a>\u00a0House Speaker Mike Johnson, and Republican members of Congress have repeated this line.<\/p>\n It\u2019s wrong.<\/p>\n Democrats have refused to vote for Republicans\u2019 resolution to extend the federal spending deadline, and their position does, in part, hinge on health care spending. Democrats want to extend covid pandemic-era Affordable Care Act subsidies that are set to expire at the end of the year and roll back Medicaid cuts in the tax and spending bill that Trump signed into law this summer.\u00a0<\/p>\n The\u00a0Democrats\u2019 proposal<\/a>\u00a0wouldn\u2019t give health care to immigrants who lack legal status; that population is already largely ineligible for federally funded health care. Instead, the proposal would restore access to certain health care programs for legally present immigrants who will lose access under the Republican law.<\/p>\n The White House did not respond to PolitiFact\u2019s request for comment for this fact check. Vance\u00a0addressed criticism<\/a>\u00a0of his talking point in another interview by saying it was included in the Democrats\u2019 spending proposal. It\u2019s not.<\/p>\n A White House X\u00a0account<\/a>\u00a0followed up with screenshots of the Democratic proposal repealing a section of the Republican law labeled \u201calien Medicaid eligibility.\u201d It\u2019s important to know that these changes would not give Medicaid access to immigrants who lack lawful status.<\/p>\n Vance defended his statement again in an Oct. 1 White House\u00a0press conference<\/a>, saying former President Joe Biden \u201cwaived away illegal immigration status\u201d that helped migrants access federal assistance. It\u2019s important to note that many people\u00a0granted lawful status<\/a>\u00a0through humanitarian parole or Temporary Protected Status programs don\u2019t automatically qualify for Medicaid; TPS\u00a0recipients aren\u2019t\u00a0eligible<\/a>, and many people who entered the U.S. on humanitarian parole are required to wait five years before accessing it.<\/p>\n The Trump administration has ended humanitarian parole and Temporary Protected Status for many people, rendering them ineligible for Medicaid and health plans on the Affordable Care Act marketplace.<\/p>\n We did not find evidence that Democrats want to spend \u201chundreds of billions\u201d in costs for insuring migrants with unlawful presence.<\/p>\n Immigrants Lacking Legal Status Are Already Ineligible<\/strong><\/p>\n Most federal health care dollars cannot be spent on health care for people in the U.S. who lack legal status. They cannot enroll in Medicaid or Medicare, and they are\u00a0ineligible\u00a0to purchase health care coverage<\/a> through the Affordable Care Act marketplace. A small Medicaid program reimburses hospitals for uninsured emergency care, which can include immigrants in the country without authorization but is not exclusive to them.<\/p>\n States\u00a0such as California and Illinois expanded Medicaid coverage<\/a> for people regardless of their immigration status, and the states pay for that. Federal law already banned states from using federal money for these programs. An\u00a0earlier version<\/a>\u00a0of the Republican spending law would have penalized such states by withholding funding, but that provision didn\u2019t last.<\/p>\n People in the country without permission might receive some federally funded health care in emergency cases; in those situations, hospitals must provide care even if a person is uninsured or in the country illegally. Emergency Medicaid covers hospital care for immigrants who would be eligible for Medicaid if not for their immigration status. The Republican tax and spending law\u00a0reduced\u00a0the amount<\/a> hospitals can receive for emergency immigrant care.<\/p>\n Most Emergency Medicaid spending is used on childbirth. In all, it represented less than 1%<\/a> of total Medicaid spending in fiscal year 2023, according to\u00a0KFF, a health information nonprofit that includes KFF Health News.<\/p>\n GOP Law Limited Care Access for Immigrants With Legal Status<\/strong><\/p>\n The Republican tax and spending law made several changes to health care eligibility for immigrants living in the country with permission. An estimated 1.4 million legal immigrants are expected to lose their health insurance, according to a KFF\u00a0analysis<\/a>\u00a0of\u00a0Congressional Budget Office<\/a>\u00a0projections.\u00a0<\/p>\n Starting October 2026, the law will restrict eligibility for Medicaid and the Children\u2019s Health Insurance Program to lawfully permanent residents, people from the Marshall Islands, Micronesia, or Palau who lawfully reside in the U.S. under an\u00a0international agreement<\/a>, and certain\u00a0Cubans and Haitians<\/a>.<\/p>\n Previously, a broad group, described as \u201cqualified noncitizens<\/a>,\u201d was eligible for Medicaid and its related Children\u2019s Health Insurance Program, known as CHIP, including refugees and people granted asylum.<\/p>\n Some immigrants eligible for Medicaid and CHIP, such as lawful permanent residents, are\u00a0required to wait five years<\/a>\u00a0before accessing the benefits.\u00a0<\/p>\n The law also limited Affordable Care Act marketplace eligibility to the same group eligible for Medicaid and CHIP beginning Jan. 1, 2027. Previously, people who were described as \u201clawfully present<\/a>\u201d were eligible. That group included the \u201cqualified noncitizens\u201d eligible for Medicaid and people with short-term statuses, such as Temporary Protected Status or international students.<\/p>\n Beneficiaries of the Deferred Action for Childhood Arrivals program, known as DACA, for immigrants who entered the U.S. without authorization as children were previously eligible for Affordable Care Act coverage and its subsidies. They are ineligible since a Trump administration\u00a0rule<\/a> took effect in August.<\/p>\n Democrats\u2019 Proposal Would Restore Legal Immigrants\u2019 Access<\/strong><\/p>\n The Democrats\u2019 Sept. 17 budget\u00a0proposal<\/a>\u00a0would, in part,\u00a0permanently extend<\/a>\u00a0the Affordable Care Act subsidies and roll back billions in Republican cuts to Medicaid and other health programs.\u00a0<\/p>\n The change would make Medicaid, CHIP, and Affordable Care Act coverage available to all legal immigrants who were previously eligible for it, such as refugees and people granted asylum.<\/p>\n The Democratic proposal would not broaden eligibility to federally funded health care programs to immigrants lacking legal status.<\/p>\n Vance said the Democratic policies would \u201cgive hundreds of billions of dollars of health care benefits to illegal aliens,\u201d and the White House did not offer its source for that figure. When Johnson\u00a0was pressed to support a similar talking point<\/a>, he referenced the Congressional Budget Office. The KFF\u00a0analysis\u00a0of CBO\u00a0estimates<\/a>\u00a0found that the Republican law\u2019s provisions related to legal immigrants would reduce federal spending by $131 billion; this projection did not include an estimate for people without legal status.<\/p>\n Our Ruling<\/strong><\/p>\n Vance said, \u201cDemocrats are threatening to shut down the entire government because they want to give hundreds of billions of dollars of health care benefits to illegal aliens.\u201d<\/p>\n Immigrants in the U.S. illegally are largely ineligible for the federally funded health care programs Medicare and Medicaid, and they cannot seek coverage in the Affordable Care Act marketplace or apply for subsidies.<\/p>\n The Democrats\u2019 budget proposal would not change that.<\/p>\n The Democrats want to restore access to certain health care programs to legal immigrants who will lose access under the Republican tax and spending law \u2014 among other measures aimed at making Medicaid and Affordable Care Act insurance plans easier to keep.\u00a0<\/p>\n Their proposal would not grant federally supported health care benefits to people in the U.S. illegally, because they did not have access to them in the first place. The small amount of funding designated for Emergency Medicaid reimburses hospitals that provide emergency care to immigrants who would be eligible for Medicaid if not for their immigration status. Finally, we did not find evidence for Vance\u2019s assertion that Democrats want \u201chundreds of billions\u201d in health benefits for migrants in the country illegally.\u00a0<\/p>\n We rate the statement False.<\/p>\n Fox News,\u00a0\u201cJD Vance Slams \u2018Preposterous\u2019 Claims on Comey Indictment: \u2018Lied Under Oath\u2019<\/a>, Sept. 28, 2025.<\/p>\n The White House,\u00a0\u201cPresident Trump Delivers an Announcement<\/a>,\u201d Sept. 30, 2025.<\/p>\n President Donald Trump,\u00a0Truth Social post<\/a>, Sept. 29, 2025.<\/p>\n U.S. House of Representatives\u00a0bill<\/a>, accessed Oct. 1, 2025.<\/p>\n Congressional Budget Office,\u00a0\u201cDistributional Effects of Public Law 119-21<\/a>,\u201d Aug. 11, 2025.<\/p>\n PolitiFact,\u00a0\u201cNewsom Championed Medicaid for Immigrants in California Illegally. Now He Wants To Cut It Back<\/a>,\u201d May 16, 2025.<\/p>\n KFF,\u00a0\u201cHealth Provisions in the 2025 Federal Budget Reconciliation Bill<\/a>,\u201d July 8, 2025.<\/p>\n KFF,\u00a0\u201cPotential Impacts of 2025 Budget Reconciliation on Health Coverage for Immigrant Families<\/a>,\u201d June 17, 2025.<\/p>\n KFF,\u00a0\u201cKey Facts on Health Coverage of Immigrants<\/a>,\u201d Jan. 15, 2025.<\/p>\n KFF,\u00a0\u201c1.4 Million Lawfully Present Immigrants Are Expected To Lose Health Coverage Due to the 2025 Tax and Budget Law<\/a>,\u201d Sept. 25, 2025.<\/p>\n U.S. Citizenship and Immigration Services,\u00a0\u201cInformation for SAVE Users: Cuban-Haitian Entrants<\/a>,\u201d accessed Oct. 1, 2025.<\/p>\n U.S. Citizenship and Immigration Services,\u00a0\u201cStatus of Citizens of the Freely Associated States of the Federated States of Micronesia and the Republic of the Marshall Islands Fact Shee<\/a>t,\u201d accessed Oct. 1, 2025.<\/p>\n Healthcare.gov,\u00a0\u201cCoverage for Lawfully Present Immigrants<\/a>,\u201d accessed Oct. 1, 2025.<\/p>\n Federal Register,\u00a0\u201cPatient Protection and Affordable Care Act; Marketplace Integrity and Affordability<\/a>,\u201d June 25, 2025.<\/p>\n\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nOur Sources<\/h4>\n
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