Congress’s anti-immigrant budget threatens health care, food assistance for NC families

Note: The US House passed a budget bill in May 2025, and the US Senate is releasing their budget proposal currently, with a vote expected in June. The two budget proposals are extremely similar: both make massive cuts to health care and food assistance to fund tax cuts for the wealthy. This post includes the latest available information on the US Senate proposals at the time of publication. For the latest updates, we recommend the Center on Budget and Policy Priorities’ Tracker.  

No matter who we are or where we come from, we all deserve the freedom to go to a doctor when we are sick and keep food on the table for our families. But right now, leaders in Congress are advancing a harmful budget proposal that would threaten these freedoms for millions of people who have come to build a life in the US. This plan would single out many legally residing immigrants and prevent them from accessing critical programs, like health care and food assistance, that families across the country count on to thrive. 

Erecting new barriers to securing the American dream is part of a calculated effort to fund tax cuts for the wealthy. And even as leaders in Congress push to take away food assistance and health care from millions of people lawfully permitted to make a home in the US, their plan would also direct billions of dollars towards an inhumane mass deportation agenda. Both plans include $45 billion for new detention facilities, including for families with children, and additional tens of billions for Immigration and Customs Enforcement (ICE) and arrests ($27 billion in the US House plan and $32 billion in the US Senate plan.) 

As President Trump and Congressional leaders continue to stoke anti-immigrant sentiment, we must make it clear that their moves would take away health insurance, food assistance, and other supports from people who have the right to care and supports. Their actions to broaden the reach of existing bars on access to services that most immigrants face won’t stop at negative impacts for those households and communities; it will ripple across North Carolina and the country in direct and indirect ways.  

The US House plan to take away health care from immigrants could, in the process, threaten Medicaid expansion that provides over 650,000 people in North Carolina with health insurance coverage. That is because a poorly written provision would reduce the federal funding share for Medicaid expansion for states, like North Carolina, that provide Medicaid coverage to certain lawfully present immigrants with humanitarian protections. North Carolina has a trigger law that states any change to the federal cost share would end coverage for those who, just a year ago, were in the insurance gap, both citizens and immigrants alike.  

These plans break a long-standing commitment to support people who have come here seeking a better life with the tools needed to make that a reality.

More North Carolinians at risk of losing health care access under federal proposals

Noncitizen immigrants — including lawfully present immigrants — are more likely to be uninsured than US citizens. Congressional budget proposals would strip away existing health insurance options for many lawfully residing immigrants and could undo Medicaid expansion for everyone in North Carolina.

Medicaid 

Given the broad-based benefits Medicaid has on communities, health care providers, and public health, North Carolina provides access to a narrow set of legally residing immigrants. Recent estimates from NC DHHS data show that about 75,000 people in North Carolina who are not citizens but legally reside in the state receive Medicaid coverage. A small portion of these are humanitarian parolees who lawfully reside in the US for humanitarian reasons. Humanitarian parolees include thousands of Afghans who supported US troops in Afghanistan, as well as Ukrainians who the US allowed to enter lawfully after the onset of war with Russia, among others.  Many parolees have suffered trauma and are in acute need of both physical and mental health care. Under the US House proposal, as noted above, the state would be financially penalized for providing coverage to humanitarian parolees. Because of the North Carolina’s “trigger law,” which repeals Medicaid expansion if the federal government reduces their share of funding, this proposal would likely lead to the end of Medicaid expansion in North Carolina for everyone, including US citizens.  

The US Senate proposal goes even further, fully stripping Medicaid eligibility from a larger group of lawfully residing immigrants, including refugees, asylees, and humanitarian parolees, and some victims of domestic violence and trafficking.  It does not include the federal funding penalty in the US House plan that could trigger the repeal of Medicaid expansion in North Carolina, but the Senate would shift new costs to states for providing federally required emergency services for immigrants who are ineligible for the full scope of Medicaid.

Medicare 

The US House and Senate plans would both take Medicare away from people with certain immigration statuses, including refugees, survivors of domestic violence, and those with Temporary Protected Status, even though these people are lawfully present, have worked in the US for at least 10 years, and paid into the program. Legally residing immigrants from North Carolina contributed $1.2 billion to Medicare in 2023. 

Affordable Care Act premium tax credits 

Both Congressional proposals would also bar many lawfully present immigrants access to the ACA marketplace premium tax credits, a key pathway to health insurance for people with low incomes who don’t receive health care through their employers or can’t access Medicaid. The plans would take away access for people with humanitarian parole, refugee status, as well as children and teens who have been abandoned or abused and those with Deferred Action for Child Arrivals (DACA).

More NC families could go hungry under proposed federal cuts 

Undocumented immigrants have never had access to SNAP, the country’s food assistance program. But under both the US House and Senate plans, SNAP benefits are taken away from legally residing immigrants who have been heavily vetted as refugees and asylees escaping violence and persecution in their home country, as well as certain immigrants who are victims of domestic violence or survivors of trafficking.    

Some 8,000 people in North Carolina would be newly excluded from participation in SNAP under these plans. The impacts aren’t limited to the people who would be excluded because of their immigration status. The children, including US-citizen children, in these households would also be hungrier, causing harm to their health and well-being for years to come. These cuts would also have financial consequences for the retail stores that accept SNAP and rely on those purchases to keep their businesses afloat, pay their employees, and keep grocery prices affordable. Over 1,400 retailers, mostly rural, would be at a high risk of losing income or closing.

Proposals undermine financial stability for NC families building a future 

Beyond the direct benefits to the health and nutrition of families, the ability to participate in these programs at a critical point in the pathway to citizenship for families arriving in this country also reduces hardship, keeps people contributing to their economy and communities, and provides significant benefits to children. 

As if the economic hit of losing health care and food assistance were not enough, these proposals would also prohibit access to key tax policies that help boost the income of households with children. Under changes to the Child Tax Credit, the US House bill would strip eligibility from 4.5 million children who are US citizens or lawful permanent residents if even one of their parents files taxes without a Social Security number (SSN). This would impact an estimated 159,000 North Carolina children. The US Senate bill would deny the credit to children if both of their parents do not have a Social Security number. While this would harm fewer children than under the House plan, the Senate proposal could still strip support from an estimated 2 million children nationwide.  

Everyone pays the price under this proposal

Every part of these federal budget plans ignores the ripple effect on all of us when health care, food assistance, and other supports for well-being are taken away. That includes the harm caused by targeting certain immigrant groups — our neighbors — whose exclusion would affect our schools, our workplaces, our main streets, and our communities.  

The Congressional budget plans would force us down a path of higher costs and more harm. We should refuse to accept them and the division that they would sow.