For stories on the science of healthy living, subscribe to NPR's Health newsletter. Mustafa Rfat has been getting frantic phone calls recently from refugees with disabilities. As of Oct. 1, refugees are losing access to Medicaid across the country because of H.R. 1, the Trump administration's major budget bill Republicans passed last summer.
"I spent these past two weeks just talking with so many of them, literally just terrorized by the reality that their children with disabilities are losing coverage," he says. "For example, a father is a refugee with disabilities, with two kids with disabilities, and he's just confused how he's going to get the medication." Rfat is a professor of social work at the University of Nebraska at Omaha, and his research focuses on refugees with disabilities, an experience he knows firsthand. When he arrived in the U.S. as a refugee from Iraq in 2011, the chronic condition that affects his spine was severe.
"I was in a very bad situation," he says. I missed my medications for a long time. So it was a very, very difficult and vulnerable situation." As he moved from Alabama to Illinois to West Virginia trying to find housing and continue his education, Medicaid was a lifeline, Rfat says.
"I had to climb this big mountain of acclimating into the culture here, learning English, dealing with the traumas of the war, the loss of family members, the challenges that I faced, being alone with a disability," he says. "I was determined and in this determination, Medicaid was the big factor that made my dreams come true." In fact, he says one of the specialists who treated him wrote his first reference to apply for college. He has since become a U.S. citizen with a family, a doctorate, and a job as a professor.
Now, he's trying to help refugees with disabilities facing the challenges of navigating life in the U.S. without that lifeline. As of Oct. 1, refugees are among the groups that will lose Medicaid coverage. Only a small portion of legal immigrants have been eligible to enroll in Medicaid, including refugees and asylum seekers.
Because of the changes to "Alien Medicaid Eligibility" in the One Big Beautiful Bill Act that Republicans passed last summer, an even smaller subset now have access. An estimated 280,000 people will lose Medicaid in October, according to an analysis by KFF Health News. That includes immigrants admitted to the U.S. on humanitarian grounds who are waiting to be approved for a green card, explains Ben D'Avanzo, senior strategist at the National Immigration Law Center.
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