'Fear and concern' as Virginia Medicaid changes cut coverage for thousands of legal noncitizens

RICHMOND, Va. — Thousands of legal noncitizens in Virginia are set to lose Medicaid coverage in less than two months under new federal rules taking effect Oct. 1 — one of several changes as a result of language included in H.R.1, also called the One Big Beautiful Bill Act, that was approved by Congress and signed by President Trump last year.

Virginia Health and Human Resources Secretary Marvin Figueroa estimates about 5,800 people will lose coverage under the new rules, which tighten restrictions on which legal non-citizens qualify for Medicaid benefits.

"This is really sad. These are individuals that previously had coverage. Nothing has changed in terms of their status," said Figueroa. "They continue to be lawfully president individuals, but because the rules change in Washington, these individuals are going to lose their coverage…These are everything from asylum to refugee populations. These are Afghan visa holders. These are also survivors of human trafficking."

While Medicaid will continue to cover groups such as legal permanent residents and Cuban and Haitian entrants, many other legal noncitizens will no longer qualify.

The Virginia Department of Medical Assistance Services (DMAS) has begun reaching out to the estimated over 5,800 people who could be impacted through letters sent at the start of August and through town halls, including a virtual one that was held Thursday.

"Starting in October, if a individual applies for Medicaid, they are not a child under the age of 19, they are not pregnant -- they must either be a lawful permanent resident, a Cuban-Haitian entrant, or a COFA migrant. That's Compacts of Free Association migrants," said Sara Cariano, DMAS Director of Eligibility Policy and Outreach.

There are limited exceptions — children under 19 and adults who are pregnant will retain coverage, as will those in a postpartum period for a limited time after giving birth.

Those who lose full coverage will only be eligible for emergency services Medicaid, which Figueroa said falls far short of what people need.

"It is very hard for a person who's on emergency Medicaid to be able to get the services they need to remain healthy," Figueroa said.

The state sent letters this month to people who may be impacted. CBS 6 spoke with an asylum seeker from South America who received one. She asked not to be identified and spoke through an interpreter.

"There is a lot of fear and concern," she said.

Health

Most states expect Medicaid shortfalls in 2026 as federal cuts loom

Justin Boggs

She said she will lose full coverage after she gives birth next month and her postpartum period ends. After that, she said she has no plan for routine care.

"Especially when I am without insurance, because hospital visits are extremely expensive, and therefore I will avoid going to the hospital or seeking care," she said. "As a consequence of not having insurance, I will have to pay or be in a high cost of accessing healthcare. So I have to pay a bill that I may not have resources for."

Shanteny Jackson is executive director of the Virginia Community Health Worker Association and said her organization supports community health workers that help communities gain access to social services.

"We serve as a bridge," Jackson said. "We bridge the community with the systems, whether it's social service system, healthcare system, and we have trusting relationships with the community. And therefore, we are able to support them on basis of understanding who they are, what their needs of their community, and how to advocate."

Jackson said community health clinics could be overwhelmed by people seeking routine care — or people will simply wait until their condition becomes an emergency.

"And then we will see an overflowing of patients into the emergency care centers," Jackson said.

National Politics

One year after passage, Trump health care law remains politically divisive

Figueroa said the state dedicated funds in the most recent budget to help community health clinics and to supplement now-expired federal subsidies on the private insurance marketplace, but acknowledged the state cannot fully replace federal dollars.

"We're doing everything possible to make sure that this law, which is intended for people to lose coverage, has as minimal impact as possible," Figueroa said.

Jackson said more must be done.

"We have to do a better job to ensuring that those who are at risk have some level of resource that can support their needs," Jackson said.

Virginia's Department of Medical Assistance Services will hold additional seminars and townhalls on the Medicaid changes. Jackson said her association will launch a mobile unit to reach communities that will be impacted.

The Oct. 1 changes are separate from additional Medicaid changes — including work requirements — set to take effect in January. State officials estimate hundreds of thousands of Virginians are at risk of losing coverage because of those changes.

CBS 6 is committed to sharing community voices on this important topic. Email your thoughts to the CBS 6 Newsroom.