Arizona refugees lose Medicaid as 11 states never sought waiver

H.R. 1 refugee cut expected to save federal government $6.2 billion

New Medicaid rules that took effect this month have left thousands of refugees in the U.S. without health coverage, according to an NPR report from member station KJZZ in Phoenix. In Arizona, a Syrian refugee, Yasin, and his family are among more than 20,000 people — mostly refugees — who no longer qualify for the program. Medicaid has never been available to undocumented immigrants, but covering refugees who are in the country legally has been longstanding policy.

The eligibility change follows H.R. 1, the Republican tax and spending bill Congress passed last year, which cut Medicaid benefits for refugees. The federal government expects to save $6.2 billion as a result. Arizona Republicans who voted for H.R. 1 did not respond to requests for comment.

Most states are still allowing Medicaid coverage for refugee children and pregnant women. Arizona is one of just 11 states that never applied for a federal waiver to do that, so refugee children and expectant mothers in the state are losing coverage.

A few years ago, Yasin, his wife and their two young sons were living in Syria amid what Yasin described as a civil war marked by indiscriminate bombings and arrests. “Our life - it was very difficult in Syria, and we don’t know if we’re going to live or not,” he said through an interpreter. The family fled and took three years to come to the U.S. legally as refugees, arriving in Phoenix in 2024 — a move he described as “safety, blessing, a happy life.” Yasin asked that his last name not be used out of concern for his pending green card application.

He said he has a job, but money is tight, and with two young sons there are always unexpected challenges. “An example - after three months, when we came to the United States, my son was playing outside. He break his leg,” he said. He said he had been grateful for the health insurance Medicaid provided, and he is now among those who no longer qualify.

Joanne Morales, who works with Catholic Charities Arizona, a refugee resettlement organization, said immediate access to health care is critical because refugees are fleeing war, genocide or persecution. “Over the years, I’ve seen clients with, like, bullet wounds that need to be addressed. Some people are survivors of torture and trauma,” Morales said.

Language skills and other barriers make it hard for refugees to get the type of jobs that offer health insurance, the report said, and refugees could become eligible for Medicaid again after they get a green card. But Morales said green card approvals have slowed during the second Trump administration. “We have cases where they’ve been waiting two or three years,” she said.

Magdalene Munezero, who works with refugees at Phoenix’s Valleywise Health, a public health system, said her team is trying to connect patients with sliding-fee clinics or charitable grants to cover medical bills and is reminding clients that Medicaid will still cover emergency visits. “Pregnant mothers are like, so what happens to us? Where are we going to go?” Munezero said. “They will keep calling you with questions that you don’t even also have the answers. They’re asking you, and you are like, what do I do?”

Yasin said he does not regret coming to Arizona. “So my important thing and the best-ever thing for me is the safety and the education for my children,” he said. But without health insurance, he wonders how safe he can keep them.