As the U.S. government ground to a halt in fall 2025 over disagreements about federal spending, Republicans centered their message around one claim: Democrats forced the shutdown to give free health care to immigrants in the country illegally.
"The Democrats shut down the government because President Trump and the Republicans will not force American taxpayers to pay for free health care for illegal aliens," White House Press Secretary Karoline
Republicans spread this talking point before and after the shutdown began: It's in an Oct. 1 ad by the Republican National Committee. It's in X posts from Vance, Speaker of the House Mike Johnson and the official Senate Republicans account. President Donald Trump claimed in a Sept. 24 Truth Social post that Democrats "want illegal aliens, many of them VIOLENT CRIMINALS, to receive FREE Healthcare." He blamed the government shutdown on this supposed demand during a Sept. 30 interview with Politico.
But the claim that Democrats were holding the government "hostage" over free health care for immigrants in the country illegally wasn't true. As of this writing, Democrats' stated top priority was an extension on tax credits that millions of Americans use to buy health insurance. The Democrats' proposal did not change the U.S. law that prohibits people in the country illegally from receiving federally subsidized health care coverage.
Thus, we have rated this claim false.
Republicans have shared misleading information about federal health care coverage eligibility for immigrants, the U.S. government's role in funding emergency care for immigrants in the country illegally and state health insurance programs in order to back up their claims. Here's a more detailed look:
Why did the shutdown happen?
Each year, the U.S. federal government must allocate all its spending money through budget bills. If those bills don't pass, the flow of money through the government effectively stops and the government (largely) shuts down. In this case, the deadline was Sept. 30.
When Congress can't agree on a budget bill, it can pass what's called a "continuing resolution," a commonly used temporary spending bill that keeps the government running while a final budget bill is hammered out. Democrats released their continuing resolution proposal on Sept. 17, and nothing in it would provide free health care to immigrants in the country illegally.
The section on health care, which starts on Page 39 and runs through Page 59, does not mention immigrants or noncitizens. Searches for the words "immigration," "immigrant," "noncitizen" and "alien" — often used in government documents to refer to immigrants — returned no results in the entire document.
What are Republicans basing their claim on?
While there was no explicit mention of immigration, the Democrats' continuing resolution, on Page 57, did call for the repeal of a provision in Trump's 2025 budget bill, which he signed into law in July, that further restricts Medicaid eligibility for noncitizens.
The White House pointed to that proposal in an Oct. 1 X post (archived) on its "rapid response account," noting that the Democrats wanted to repeal the "Alien Medicaid eligibility" section of Trump's "Big, Beautiful Bill."
Johnson, the House Speaker, referenced Page 57 of the Democratic proposal on Oct. 3 and claimed it would restore "taxpayer-funded benefits for illegal immigrants":
But the section of the budget bill that Democrats want to repeal sets new limitations for Medicaid eligibility for noncitizens who are lawfully present in the United States, not for those in the country illegally. The budget bill allows only those who were lawfully admitted and other specific immigrants with legal status to access these benefits. (In federal legal parlance, "alien" means "noncitizen," either in the country legally or not.)
The 2010 Affordable Care Act — which helped expand Medicaid access — originally defined those eligible for its programs as a "citizen or national of the United States or an alien lawfully present in the United States." There's no one definition of "lawfully present," and different administrations have expanded or excluded certain groups of people from the category when determining who is eligible for health care coverage under the ACA, also known as Obamacare. Crucially, however, the definition before Trump's second term included only people who have authorized or legal immigration status, such as refugee and asylum recipients or Deferred Action for Childhood Arrivals beneficiaries, who came to the country illegally but have been given permission to stay.
In other words, the immigrants eligible for Medicaid are not "illegal immigrants" because they are going through legal channels.
Republicans have argued that former President Joe Biden's administration abused the definition of legal presence. In September, three Republican budget committee chairmen cited a Congressional Budget Office analysis to back up this claim and alleged the CBO determined "1.2 million illegal immigrants or non-citizens" would lose health coverage. The actual CBO analysis simply said "noncitizen."
Emergency Medicaid care
While federal law prohibits immigrants in the country illegally from receiving federally subsidized health care coverage plans, there are exceptions in federal law that allow immigrants to receive federally subsidized care. Hospitals, for example, legally must perform emergency care for people who would qualify for Medicaid if not for their immigration status. Republicans cut reimbursements hospitals receive when performing that kind of care; Democrats want to reverse those cuts.
Republicans have pointed to this specific dispute as another example of Democrats giving "free health care" to people in the country illegally — but neither party has attempted to change the law around hospitals being required to perform that kind of care, meaning it's still false to claim that Democrats shut down the government to give immigrants emergency health care.
State programs for undocumented immigrants
Vance, in an Oct. 1 X post, pointed to a New York state program providing immigrants in the country illegally with health care to back up his claims. He appeared to be referencing what the White House called the "California Loophole," which allegedly allows states such as California to use federal funds for Medicaid. However, these state programs are not funded by the federal government — because, again, that's illegal.
In some cases, the federal government does play a small role, but that doesn't mean it provides funding. Take a look at Washington state, for example. In 2022, the state requested what's called a Section 1332 waiver from the federal government, a type of waiver developed under the ACA to allow states to try "innovative strategies" for providing residents with health care. Washington's waiver allowed people, regardless of immigration status, to purchase a non-federally subsidized qualified health or dental plan.
In this case, the Biden administration approved the waiver, but the money came from the state, not the federal government.
"About 14 states and DC provide some form of coverage to some immigrants, usually children, regardless of immigration status using only state dollars," Leonardo Cuello, a research professor at Georgetown University with a background in Medicaid law, wrote in a May 2025 explainer about the Republicans' Medicaid cuts. "These state programs do not use federal Medicaid dollars, are not subject to Medicaid standards and requirements, and are not, by definition, Medicaid."
What do Democrats actually want?
Democrats' top stated priority is a permanent extension on tax credits that millions of Americans use to buy health insurance. Democrats first established the "premium tax credit" through the Affordable Care Act in 2014. These tax credits help keep costs down, and because they're paid for by the federal government, immigrants in the country illegally aren't eligible for them.
While the original credit does not expire, Democrats expanded the subsidy program as part of COVID-19 relief legislation — but set Jan. 1, 2026, as the expiration date for the expanded offerings. They're now asking Republicans to permanently extend that date.
Senate Minority Leader Chuck Schumer spoke about the Democrats' demands during a Sept. 30 news conference:
We see now Republicans are plunging America into a shutdown—rejecting bipartisan talks, pushing a partisan bill, and risking America's healthcare, worst of all. A few moments ago, Republicans once again rejected Democrats' proposals to avoid a shutdown, fix healthcare premiums, and spare Americans the calamity of skyrocketing, through-the-roof healthcare costs. Republicans blocked it again, once again.
[…]
There are going to be millions of American families in the next week, in October, sitting down and saying, "How are we going to pay these damn bills? What do we have to cut to pay these bills? Or should we cut our health insurance or drop it altogether?" It's estimated over 4 million people will.
And why are those costs going up? Simply because the Republicans refused to extend the ACA credits. That's all. And you say, well, negotiate it with them? Well, we want to, but they rejected it three times in three different bills. And now it's on their backs.
Bottom line is we need to stop these premiums from going up dramatically. We need to do it now, not in October when people get the notices, not in November when they have to decide whether to drop healthcare or reduce the healthcare they get. And this is not a left, right, or center issue. This is to help the American people into one of the things they are most, most worried about.
So, we hope they sit down with us and talk. Otherwise, it's the Republicans who will be driving us straight towards a shutdown tonight, and at midnight the American people will blame them for bringing the federal government to a halt.
As Schumer referenced, the Democrats' continuing resolution proposed an extension on these credits (see Page 57, Line 15 — "PERMANENT EXTENSION OF ENHANCED TAX CREDIT" — underneath "Subtitle E — Other Health Provisions").
There are a few other sticking points for the Democrats, largely focused on health care funding and affordability. For example, Democrats are asking for a reversal of steep Medicaid cuts made in the budget bill Trump signed in July. They're also looking for provisions protecting against "impoundments and rescissions," when the president withholds or rescinds funding already appropriated by Congress. (That's how Trump rescinded public-media funding and foreign aid in July. The controversial maneuver Trump used has faced legal challenges.)
Here's Schumer's Sept. 30 response to a reporter asking the senator what it would take to avoid a shutdown:
REPORTER: Yesterday, you said after the White House meeting that you told Trump and the Republicans that it would take two things from your bill and put them in to avoid a shutdown, that was the ACA credits and the provisions on impoundments and rescissions. You did not mention the provision that would roll back the Medicaid cuts. Is that still a demand for Democrats or is that something you guys –
SCHUMER: Look, we care about everything. We care about health care across the board. I wanted to start off with the president with a couple of things, but it's not an exclusive list.
The bottom line
The Democrats' proposal to fund the federal government did not suggest funding free health care for immigrants in the country illegally. If passed, it would have repealed a provision limiting Medicaid eligibility for immigrants with legal status, not for people in the country illegally. It also would have reversed Republican cuts to reimbursements for hospitals legally required to provide emergency care for people in the country illegally who would be eligible for Medicaid if not for their immigration status.
Republican talking points about Democrats' role in the shutdown also focused on state programs that provide health insurance to undocumented people, but those are not federally funded.
Furthermore, the Democrats' top priority, according to their leadership, is a permanent extension for tax credits that help millions of Americans afford health care. Immigrants in the country illegally are not eligible for this tax credit program.