The White House and congressional Republicans say that Democratic lawmakers caused the federal government shutdown as part of an effort to extend health care benefits to undocumented immigrants. However, as several independent experts interviewed by NPR note, that claim is false.
At the center of the standoff is the Trump administration's Working Families Tax Cut Act, also known as President Trump's "One Big Beautiful Bill," signed into law in July.
Democrats say it amounts to tax breaks for billionaires and pays for them with deep Medicaid cuts. The White House insists the law protects taxpayers by preventing undocumented immigrants from getting government health benefits — but such individuals were already barred from Medicaid and the Affordable Care Act (ACA), or Obamacare, exchanges.
"It's a complete distortion," says Leighton Ku, the director of George Washington University's Center for Health Policy Research. It is "simply wrong in the details," he says.
In the weeks ahead of the Oct. 1 start of the new fiscal year, when funding for the federal government was due to expire, GOP lawmakers introduced a continuing resolution to extend the funding until Nov. 21. But Democrats demanded that it also include an extension of ACA subsidies — set to expire at the end of the year — and the reversal of Medicaid cuts.
Republicans have accused the Democrats of holding the government hostage to a "far-left wish list," including funding the health care of "illegal aliens." The White House has said the Republicans' legislation ensures "that taxpayer dollars are focused on American citizens and do not subsidize healthcare for illegal immigrants."
Jonathan Gruber, the chairman of the Economics Department at the Massachusetts Institute of Technology, says the Republican claim is false. People living in the U.S. who are undocumented "do not qualify for Medicaid. They do not qualify for tax credits on the [ACA health care] exchanges," he says.
KFF, a nonprofit, nonpartisan organization that analyzes national health issues, notes that U.S. health coverage programs for immigrants are generally limited to those lawfully present. Medicaid and CHIP — which provides low-cost coverage to uninsured children and pregnant women — are restricted to immigrants with a "qualified" status, such as refugees and asylees, most of whom must wait five years before enrolling.
Subsidized ACA Marketplace coverage is available to these qualified immigrants as well as others, including those with Temporary Protected Status or certain work visas, while Medicaid eligibility is limited to lawfully present immigrants who meet age and work requirements, according to KFF. The Center for Children & Families at the McCourt School of Public Policy at Georgetown University has also fact-checked the claim and come to a similar conclusion.
By contrast, some states provide fully-state-funded medical care for some undocumented individuals, but even those programs are being rolled back. Beginning next year in California, for example, undocumented adults will no longer be able to enroll in that state's Medi-Cal program, although children will still be covered regardless of their immigration status.
Gruber, who has worked on health and health care coverage policy for several decades, says the shutdown "isn't about undocumented immigrants getting health care. It's about cutting health insurance" for millions of low-income Americans.
The Congressional Budget Office estimates that the federal spending on Medicaid and the Supplemental Nutrition Assistance Program, or SNAP — another priority for Democrats — will be reduced by more than $1 trillion over the next decade as a result of provisions in the One Big Beautiful Bill.
Ku, of George Washington University, says part of the confusion is over the definition of who is and who isn't undocumented. "Sometimes when Republicans use the phrase 'illegal immigrant,' they include people who actually have legal status — like asylees, refugees, or those with Temporary Protected Status — just because they don't like them."
Although Emergency Medicaid does technically cover undocumented people, it serves mainly as a backstop for hospitals, who are required by law to treat patients turning up in emergency rooms, regardless of their immigration status. "Medicaid just helps hospitals cover those costs," Ku says.
"Emergency Medicaid is one or two billion dollars out of a trillion-dollar program. It's a tiny fraction," he adds. "This is a tail-wagging-the-dog problem. These issues are a minuscule part of Medicaid and ACA spending, but they're being blown up into something they're not."
Gruber says health care is a complicated issue and "the more complicated the issue, the easier it is to make a misleading claim."
An NPR/PBS News/Marist poll published earlier this week found that 38% of Americans blame Republicans for the shutdown, 27% blame Democrats, and 31% believe both parties are to blame.
He says that for Republicans, claiming the shutdown is about extending health care to undocumented individuals "sounds good, it feels good, and it plays into the idea that people who 'don't look like they belong here' are getting benefits. But it's just not true."
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