Sixty-three members of Congress asked U.S. Citizenship and Immigration Services (USCIS) to expedite pending green card applications for lawfully present immigrants losing, or at risk of losing, healthcare coverage. The request follows eligibility restrictions under the One Big Beautiful Bill Act (OBBBA) that took effect October 1. The lawmakers want an administrative response.
The letter went to agency Director Joseph B. Edlow. It was dated October 14 and made public on October 19.
Democratic Reps. Yvette D. Clarke of New York and Adelita S. Grijalva of Arizona led the effort. Indian-American lawmakers Raja Krishnamoorthi, Pramila Jayapal and Shri Thanedar signed with 58 other members.
Coverage losses threaten immigrants waiting for decisions
The lawmakers say the restrictions could leave thousands without health coverage while their applications for permanent residence remain pending. The groups they identify include refugees, people granted asylum, and survivors of domestic violence and human trafficking.
The programs at issue include Medicaid, the Children's Health Insurance Program, Medicare and Affordable Care Act premium credits. Some affected immigrants, the members argue, could qualify for continued federal healthcare benefits after gaining permanent residence. They may lose coverage during the wait.
More than 281,000 lawfully present immigrants in nine states and Washington, D.C., were identified as facing Medicaid coverage loss. That figure concerns coverage, not pending applications.
The Congressional Budget Office projects that 1.4 million lawfully present immigrants will become uninsured by 2034 under the restrictions. It is also an estimate of insurance losses, not the size of the application backlog.
Grijalva said more than 20,000 lawfully present refugees and immigrants in Arizona faced a risk of losing coverage. She cited a woman with stage-four metastatic breast cancer and a nine-year-old boy with epilepsy.
The Arizona woman lost Medicaid on October 1. She is lawfully present, but delays in her application have left her without coverage for the chemotherapy she depends on to survive. Grijalva highlighted her case.
The request targets emergency processing and coverage terminations
The lawmakers proposed three administrative steps. Their letter asks the agency to:
- Set up emergency expedited processing for
Form I-485applications when a person faces imminent healthcare coverage loss while an application is pending. - Revise or clarify expedited-processing criteria to recognize impending loss of federal or state coverage as grounds for action under severe financial loss or humanitarian considerations.
- Coordinate with the Centers for Medicare & Medicaid Services and state agencies on guidance that could delay coverage terminations for people with pending applications.
The form allows eligible immigrants already in the United States to seek adjustment of status to lawful permanent residence. The request is aimed at people whose healthcare coverage is threatened while the agency considers their cases.
The proposed coordination would involve both federal and state officials. The letter asks for guidance on delaying terminations, rather than describing a change already in place.
Clarke says delays can leave families without care
Clarke described the effect of the backlog in stark terms. “Needless red tape should never be the determinant between life and death,” she said.
The lawmakers contend that some applicants have already waited any required period to qualify for federal eligibility as lawful permanent residents. They say those people are losing insurance because their applications remain caught in an administrative bottleneck that the agency can address.
They also warn that coverage gaps could raise costs for federal and state governments. Patients who delay preventive treatment may become sicker before receiving care, the members argue.
Healthcare eligibility depends on immigration category, program rules and any applicable waiting periods. The letter does not say that every person with a pending application qualifies for continued coverage.
The agency has not committed to the requested changes
The members asked for a prompt response describing what steps the agency would take. Their letter does not establish that officials agreed to expedite applications or implemented any of the requested administrative changes.
The request leaves the next action with the agency: respond to the lawmakers and outline its plans for addressing the backlog and coverage losses.
