Starting this Thursday, Florida faces a significant challenge as federal Medicaid restrictions are set to impact the largest number of immigrants in the United States. Approximately 177,000 individuals have been flagged by the state as potentially losing their healthcare coverage beginning October 1st.
Anna Holaday, a spokesperson for Florida's Department of Children and Families (DCF), confirmed these figures to KFF Health News. Their investigation, spanning nine states and the District of Columbia, estimated over 281,000 immigrants might be affected nationwide.
Florida is at the forefront of this issue, with North Carolina following at around 29,000 affected individuals, Arizona with nearly 28,000, New Jersey between 15,000 and 25,000, and Washington with about 11,000.
The Cuban Community's Unique Position
The law, however, provides a crucial safeguard for the Cuban community, as "Cuban/Haitian entrants" remain eligible for Medicaid, provided they meet other requirements. This protection is particularly relevant given the changes enacted by the One Big Beautiful Bill Act, signed by President Donald Trump on July 4, 2025.
As of October 1, 2026, the Centers for Medicare and Medicaid Services (CMS) guidelines state that federal funding for comprehensive Medicaid coverage is primarily reserved for U.S. citizens and nationals, with exceptions for lawful permanent residents, Cuban/Haitian entrants, and those covered under the Compact of Free Association (COFA).
Impact on Florida's Cuban Residents
For many Cubans residing in Florida, the eligibility category "Cuban/Haitian entrant" is key. The DCF clarifies that this category includes Cuban and Haitian nationals who have been granted parole, applied for asylum, or are undergoing removal proceedings.
The CMS federal guidelines specifically include Cuban/Haitian entrants among those non-citizens who remain eligible for federal Medicaid funding post-October 1st changes. However, merely being Cuban isn't enough; the DCF must verify that individuals meet the criteria for eligible immigration categories.
Understanding the I-220A Form
For Cubans who have arrived in recent years, understanding the implications of the I-220A form, Order of Release on Recognizance, is essential. This form does not grant immigration status or equate to parole. However, it doesn't automatically exclude Cubans from the Cuban/Haitian entrant category.
The federal SAVE system of USCIS indicates that Cubans with an I-220A can be recognized as Cuban/Haitian entrants if they are in removal proceedings and not under a final, non-appealable deportation order.
Guidelines for Medicaid Coverage
Receiving a notification from the DCF doesn't automatically mean a loss of Medicaid benefits. The agency is verifying the immigration status of non-citizens through the federal SAVE system. If they can't automatically verify eligibility, they request additional documents.
Those who receive such a notice should respond promptly with the necessary documentation. Failure to do so by September 30, 2026, could result in the termination of coverage. Documentation can be submitted via the MyACCESS account or through methods specified in the notice.
For those who no longer qualify for full Medicaid due to immigration status, CMS clarifies that emergency Medicaid remains available for certain medical emergencies, which is not equivalent to regular coverage.
Anticipating Wider Effects
The figure of nearly 177,000 potentially affected in Florida is not the final count. KFF Health News notes that the state identified these individuals through initial immigration record checks but allowed them to submit additional proof of eligibility. Final numbers will be determined later.
Nationally, the impact of the healthcare reform will be substantial. The Congressional Budget Office (CBO) projects that Medicaid changes could increase the uninsured population by 7.5 million by 2034, though this figure includes various provisions beyond immigration restrictions.
For Cubans in Florida, the primary takeaway is that the law does not revoke Medicaid for all Cuban immigrants. The Cuban/Haitian entrant category remains protected. However, recipients of a DCF notice must verify their status and provide requested documentation rather than assuming automatic eligibility.
Frequently Asked Questions About Medicaid Coverage Changes in Florida
Who is affected by the new Medicaid restrictions in Florida?
Approximately 177,000 immigrants in Florida are identified as potentially losing Medicaid coverage due to new federal restrictions.
Are Cuban immigrants protected under the new Medicaid rules?
Yes, Cuban immigrants categorized as Cuban/Haitian entrants remain eligible for Medicaid, provided they meet other criteria.
What should recipients of DCF notifications do?
Recipients should respond with the required documentation to verify their eligibility for Medicaid. Failure to do so might result in losing coverage.