Professor Medha D. Makhlouf comments on the impact of cuts to federal health spending

CARLISLE, Pa.—Professor Medha D. Makhlouf was recently interviewed for a Stateline article about how provisions of the 2025 federal tax and budget law will limit states’ ability to provide access to health care for immigrants. The article, “1.4M Lawfully Present Immigrants Could Lose Subsidized Health Coverage,” describes how changes in the eligibility criteria for federal health care programs will shift the costs of covering immigrants to states. These changes, alongside extensive cuts to federal spending on Medicaid, will require states to make difficult decisions about whether and how to assure immigrant access to health care.

Makhlouf drew on her research about the laws and policies affecting immigrant access to health care to describe states’ legal authority to create subsidized health insurance programs for immigrants who are excluded from federal programs. However, as she noted in the article, states will find it difficult to do so given that many more U.S. citizens and eligible immigrants are likely to lose Medicaid coverage, with consequent losses of federal funding for the state.

Makhlouf described why the funding cuts and immigrant eligibility restrictions should matter to everyone, regardless of their immigration status: “Everyone who cares about access to health care needs to pay attention to what’s happening to immigrants,” she said. “When it becomes normalized to be able to sacrifice certain people’s humanity or their vulnerability, or to minimize their contributions to society, and say, ‘You don’t deserve access to health care,’ then that can be turned on to any group.”

Stateline is part of States Newsroom, the nation’s largest state-focused nonprofit news organization covering big challenges and policy trends that cross state boundaries, with an emphasis on how different states are grappling with the same challenges.

Professor Medha D. Makhlouf is the Elsie de R. and Samuel P. Orlando Distinguished Professor and founding director of the Medical-Legal Partnership Clinic at Penn State Dickinson Law. She has a joint appointment in the Department of Public Health Sciences at Penn State College of Medicine. Professor Makhlouf’s research and teaching interests lie at the intersection of health law, immigrants’ rights, and poverty law and policy. Her recent scholarship has been published in the Boston University Law Review, New York University Law Review, and the Yale Journal of Health Policy, Law & Ethics. Professor Makhlouf is currently writing a book, tentatively titled Health Justice for Migrants, which is under contract with Cambridge University Press.