State data indicates that hundreds of thousands of lawfully present immigrants are at risk of losing government health coverage beginning October 1. This development suggests the impact of Medicaid changes in President Donald Trump’s 2025 signature legislation may be greater than previously anticipated. The One Big Beautiful Bill Act, passed by congressional Republicans, is expected to reduce spending on the state-federal health program for low-income individuals and people with disabilities by more than $900 billion through 2034. Under this law, many lawfully present immigrants are projected to be among the first to lose their Medicaid coverage. The legislation is also set to strip additional immigrants of their Affordable Care Act plan subsidies and Medicare coverage next year.