FACT FOCUS: Democrats did not shut down the government to give health care to 'illegal immigrants'

AP-President Donald Trump and other high-ranking Republicans claim Democrats forced the government shutdown fight because they want to give free health care to immigrants in the U.S. illegally.

Democrats are trying to extend tax credits that make health insurance premiums more affordable on marketplaces established by the Affordable Care Act, commonly known as Obamacare, and reverse Medicaid cuts in Trump's big bill passed this summer. But immigrants who entered the country illegally are not eligible for either program.

Here's a closer look at the facts:

CLAIM: Democrats shut down the government because they want to give free health care to immigrants who entered the U.S. illegally.

THE FACTS: This is false. Democrats say they are pushing for the inclusion of key health care provisions in the next congressional spending package. In particular, they are seeking an extension of tax credits that millions of Americans use to buy insurance on the Affordable Care Act exchange and a reversal of Medicaid cuts made in the bill Trump signed into law in July. However, immigrants in the U.S. illegally are not eligible for any federal health care programs, including insurance provided through the Affordable Care Act and Medicaid. Hospitals do receive Medicaid reimbursements — which would be reduced under Trump's bill — for emergency care that they are obligated to provide to people who meet other Medicaid eligibility requirements but do not have an eligible immigration status, according to KFF, a nonprofit health policy research, polling and news organization. This spending accounted for less than 1% of total Medicaid spending between fiscal years 2017 and 2023.

Sabrina Corlette, founder and co-director of Georgetown University's Center on Health Insurance Reforms, called the Republicans' claims "a flat-out lie."

"The law is very clear," Corlette said.

Speaking in the Oval Office on Tuesday about a deal with Pfizer to lower drug prices, Trump predicted the shutdown and made the false claim: "We'll probably have a shutdown because one of the things they want to do is they want to give incredible Medicare, Cadillac, the Cadillac Medicare, to illegal immigrants." He added later that "they want to have illegal aliens come into our country and get massive health care at the cost to everybody else."

Asked by a reporter to clarify what his comments referred to, Trump said "when an illegal person comes, a person who came into our country illegally, therefore breaking the law," adding that "we just as a country cannot afford to take care of millions of people who have broken the law coming in."

Other Republicans, including Vice President JD Vance and House Speaker Mike Johnson, have made similar claims.

The Senate's Democratic leader, Sen. Chuck Schumer, rebutted these allegations, calling them "a lie, plain and simple."

Immigrants in the U.S. illegally are not eligible for insurance bought on the Affordable Care Act exchange or for Medicaid. To qualify for the former, an enrollee must live in the U.S., be a U.S. citizen or have another lawful status and not be incarcerated. A Medicaid enrollee must meet certain financial requirements, be a resident of the state in which Medicaid is being received and be a U.S. citizen or have a qualifying lawful status.

Health care premiums for millions of Americans could skyrocket if Congress fails to extend tax credits that many people use to buy insurance through Affordable Care Act marketplaces. Those subsidies were put in place during the COVID-19 pandemic but are set to expire.

Among the Medicaid cuts Democrats are seeking to reverse is a reduction to reimbursements hospitals receive when they perform emergency care they are legally mandated to provide on people who would qualify for Medicaid if not for their immigration status. This would affect the 40 states, plus Washington, D.C., that have adopted a Medicaid expansion created by the Affordable Care Act.

The law Trump signed would also restrict the eligibility of lawfully present immigrants such as refugees and asylees for insurance through the Affordable Care Act, Medicaid and Medicare.

Some states use their own money, not federal funds, to provide health care to immigrants who don't have lawful status. An earlier version of Trump's tax breaks and spending cuts bill tried to curb these programs, but the provisions did not make it into the final version.

"It's a compelling talking point to say that Democrats want to provide health care to undocumented immigrants, but it's just not true in terms of the cuts they're trying to reverse," said Larry Levitt, executive vice president for health policy at KFF.

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This story was first published on Oct. 1, 2025. It was published again on Oct. 3, 2025, to correct that to qualify for insurance bought on the Affordable Care Act exchange, not for Medicaid, an enrollee must live in the U.S., be a U.S. citizen or have another lawful status and not be incarcerated.