More than a thousand immigrants in Maine will lose their health insurance starting Oct. 1, due to Medicaid eligibility changes passed through President Donald Trump’s 2025 budget law.

H.R. 1 made significant cuts to the national health insurance program that millions of low-income households rely on, removing certain groups of immigrants, as well as adding work requirements that together will result in at least 7 million people nationwide losing their coverage.

On Thursday, the first of those major changes took effect, meaning refugees, asylum seekers, victims of sex trafficking and abuse, and noncitizen veterans —all of whom are in the U.S. with permission from the federal government — are now excluded from the program. The law does not affect coverage for children under 21, pregnant people and green card holders. 

“They’re losing their healthcare only because of their immigration status, not because their income is too high or because they’re not complying with a requirement,” said Alex Carter, senior policy advocate at Maine Equal Justice.“There is no good rationale other than cruelty.”

The Maine Department of Health and Human Services has been sending notices to hundreds of households since June informing them of this change.

Michelle Probert, director of the Office of MaineCare Services, said at an annual healthcare conference in September that although the number of people losing care is not high, the kind of care they need is important to consider.

“When we look at what they have been receiving, these are some of our highest needs individuals,” Probert said at the Sept. 3 Consumers for Affordable Health Care conference. “They have a disproportionate utilization of home and community-based services because of the disabilities that they have. They also have disproportionate diagnoses of serious mental illness.”

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When health insurance is stripped away from high-needs populations, research has shown that they put off timely care, instead waiting until their condition turns dire. That’s what may happen in Maine, where healthcare infrastructure is already under strain, Carter said.

Already, people that Maine Equal Justice works with have had medically necessary procedures like transplants canceled because they won’t be able to pay for the necessary follow-up care after they lose their MaineCare coverage, she told Maine Morning Star.

“I think one of the greatest myths about so many of these changes is that it’s about saving money,” she said. “But when people go without necessary healthcare and treatment, the long-term effects of that are much higher, healthcare costs and a much higher burden on our healthcare system.”

Some other states have tried to fill in the Medicaid coverage gaps with state-funded programs, including California, New York and Pennsylvania. In Maine, there is no such plan yet.

Last session, Maine House of Representatives Speaker Ryan Fecteau introduced a $250 million bill that would have bolstered several healthcare programs, including allocating $105 million to the Department of Health and Human Services to make up for federal reductions to the state’s Medicaid program. That bill did not pass likely because of its significant cost.

Carter said the Legislature could expand the state program “to cover this group of people, or another group of people with high healthcare needs.” She said it’s “all about fiscal priorities,” and the priorities of the new governor, who will be elected on Nov. 3. The three candidates have vastly different plans to address the challenge of healthcare affordability. 

Even more Mainers are set to lose healthcare next year, either because of eligibility changes or voluntarily due to record-high marketplace insurance premiums. The immigrants who are losing Medicaid on Oct. 1  will also no longer be able to purchase plans on the health insurance marketplace.  

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