Thousands of immigrants will lose Medicaid on October 1 in Illinois, but some will keep coverage.

Millions of migrants in Illinois will lose access to Medicaid starting October 1, according to new state guidelines issued by the Department of Healthcare and Family Services (HFS). The changes, effective from October 1, 2026, will impact eligibility and benefits for non-citizens under federal regulations. Some groups, however, will retain their health coverage based on specific criteria outlined by the state. The new federal rules require non-citizens who do not meet strict eligibility standards to automatically lose their Medicaid coverage beginning October 1. Those affected will no longer qualify for federally funded healthcare services. The state agency, HFS, has stated it will notify individuals who must take action to maintain their coverage through official communications. Beneficiaries who need to perform specific actions will receive notifications, while others will be informed prior to any change in their coverage status. Certain migrant populations will remain eligible for Medicaid despite these changes. Specifically, families receiving assistance through programs such as SNAP, TANF, or Medicaid will be automatically eligible for continued coverage. Non-citizens not part of these family-based programs will not be able to keep their Medicaid benefits and will lose access to the program. Starting in 2027, additional work requirements will apply to adults aged 19 to 64 without minor children living at home. These individuals must either earn more than $580 per month or complete 80 hours of work-related activities each month. Eligible activities include part-time education, volunteer work, self-employment, and participation in job training programs. The state will reduce the renewal period for Medicaid coverage from 12 months to six months for this group. Exemptions from the work requirement include pregnant women, former foster youth under 26 years old, and veterans with total disabilities. Individuals who lose their benefits due to failure to comply with these conditions can seek alternative insurance options through the state’s Get Covered Illinois platform. However, they will no longer be eligible for premium subsidies that lower the monthly cost of private insurance plans. The policy shift reflects broader national trends in healthcare reform, particularly regarding the expansion of Medicaid and the implementation of work requirements for certain populations. While some states have adopted similar measures, others have resisted, arguing that such policies disproportionately affect vulnerable communities. In Illinois, the decision comes amid ongoing debates over immigration policy and public resource allocation. Healthcare advocates and community organizations have expressed concern over the potential impact on low-income residents, especially those who rely on Medicaid for essential medical care. They argue that the new rules could create barriers to accessing necessary treatments and exacerbate existing disparities in healthcare access. Meanwhile, state officials emphasize that the changes align with federal mandates and aim to ensure responsible use of taxpayer funds. As the deadline approaches, efforts are underway to inform affected individuals about their rights and available alternatives. Local agencies and nonprofits are working to provide guidance and support to help people navigate the transition. The outcome of these developments will likely shape future discussions on healthcare policy and immigrant integration in Illinois.