Every Arkansas family deserves access to health care. But new federal restrictions that took effect October 1, 2026, make it harder for many legally present immigrants to get the care they need. The changes taking effect this month are part of H.R. 1 (also known as the “One Big Beautiful Bill Act”) that Congress passed in 2025. It strips Medicaid eligibility for several groups of lawfully present immigrants, including refugees, people granted asylum, and victims of human trafficking. These are our neighbors and community members who have often fled violence and persecution to call Arkansas home.
One point I want to emphasize right away is not all immigrants are losing coverage. Understanding those protections can help families keep the coverage for which they qualify. This may also be useful for organizations that support our immigrant communities to better navigate these confusing changes.
What changed on October 1, 2026?
The federal government narrowed the groups of immigrants who will remain eligible for Medicaid coverage, from nine groups to only three. H.R. 1 only cut full Medicaid eligibility for lawfully present, documented immigrants in Arkansas. Medicaid already excluded many from full Medicaid benefits (including student/work visas, temporary protected status (TPS), admissions of people for under a year, and undocumented immigrants).
Those losing eligibility include:
- Refugees and people granted asylum
- Individuals paroled into the United States for at least one year (example: humanitarian admissions)
- Survivors of domestic violence who petition under the Violence Against Women Act
- Victims of human trafficking
- Certain Iraqi/Afghan/Ukrainian immigrant visas
- Individuals admitted as conditional entrants prior to 1980
Some people in the groups listed above may still qualify through another pathway, such as having a green card or qualifying for the protections for children and pregnant women (explained more below).
The three immigrant groups that remain eligible for full Medicaid benefits include:
- Legal Permanent Residents (LPR), aka “green card” holders — though they can be subject to a five-year waiting period
- Certain Cuban and Haitian entrants
- Compact of Free Association (COFA) migrants — from the Marshall Islands, Micronesia, Palau
Arkansas children and pregnant women still have protections
For more than 20 years, Arkansas has taken a federal option that allows immigrant children under age 19 and pregnant women to get coverage without a five-year waiting period.
That protection remains in place. It means a refugee child, for example, can still qualify for ARKids First even though the new law cuts off the usual coverage pathway for refugees. Pregnant women, regardless of immigration status, also have a pathway for temporary Medicaid coverage through a temporary program (From Conception to End of Pregnancy a.k.a. the “Unborn Child Option”). Families must still meet the program’s other requirements. These protections matter. Families should not assume that a child or pregnant family member has lost eligibility because another adult in the household lost coverage.
Emergency care is still covered in some circumstances
Emergency Medicaid also remains available for qualifying medical emergencies, including labor and delivery, for people who meet the other Medicaid requirements but cannot qualify because of immigration status. It covers treatment of the qualifying emergency, rather than ongoing coverage for routine doctor visits and prescriptions.
Marshallese Arkansans remain eligible
As referenced above, Marshallese families also remain eligible. The October 1 restrictions do not take away Medicaid eligibility for Marshallese Arkansans living here under the Compact of Free Association (the same protection applies to people from the Federated States of Micronesia and Palau).This is especially important in Arkansas, having the largest Marshallese community outside of the Marshall Islands. AACF worked alongside Marshallese advocates and organizations for years to restore access to Medicaid. Arkansas implemented restored coverage for Marshallese adults in 2021, after federal policy had excluded them for roughly 25 years. Families should not lose that hard-won access because of confusion about this new law.
What families can do
If you receive a letter saying coverage is ending, read it carefully and get help promptly. Ask Arkansas DHS to explain:
- Which household member the notice applies to
- Whether that person qualifies through another coverage pathway
- How to appeal the decision and what deadlines apply
Tell the person helping with your application if someone is pregnant or has obtained a green card or another immigration status since their last application.
And again, a parent losing coverage does not automatically mean their child loses coverage. Each person’s eligibility must be considered separately.
Taking coverage from parents hurts children too
Keeping a child eligible for coverage does not protect that child from every consequence of a parent becoming uninsured. When a parent cannot afford medicine or treatment, an illness can make it harder to work, pay bills, and care for children. Medical expenses can leave less money for groceries, rent, and transportation. Children carry that stress, too.
Confusing rules can cause additional harm. A family may hear that “immigrants are losing Medicaid” and assume no one in the household qualifies. Parents may hesitate to renew a child’s coverage or seek care, even when the child remains eligible. Families that include both citizens and noncitizens are particularly vulnerable to this fear and confusion.
Arkansas should make every effort to prevent these avoidable losses. DHS should provide clear notices in families’ primary languages, help people understand their options, and make sure eligible children and pregnant women keep their coverage. Families should not be afraid to make sure their children get the care for which they are eligible.
Speak up for Arkansas families
Taking health coverage away from people who have sought safety and built lives in our communities is cruel and harmful. It puts parents’ health at risk and threatens the stability children need to thrive. Our members of Congress need to hear why these restrictions should be reversed. State policymakers need to hear why Arkansas must use every available protection to keep families covered.
Join Arkansas Advocates for Children and Families in speaking up. Sign up for our updates and action alerts, contact your policymakers, and help us explain what these changes mean for Arkansas families. If you work with families who are losing coverage, delaying care, or struggling to understand the rules, reach out to share what you are seeing without sharing anyone’s personal information without their permission.
If you have a story to share, we also encourage you to record a video via our Soapbox platform, which can be found here. Sharing your experience can help others better understand what’s at stake for communities across the country. We want to hear from you.
Together, we can push for policies that give every Arkansas child and family a fair chance to be healthy.
