How Trump's Bill is neither big nor beautiful for Indians in US
Of the 2 million Indian immigrants (as per MEA's March 2025 data), over 4.2 lakh are Indian students, as per a US government report.While immigrants on student visas in the US are not eligible for federal healthcare schemes such as Medicaid, and most rely on university-sponsored health insurance during their studies, a critical gap arises during the transition from student life to employment.Once they graduate, their university coverage ends, leaving many without any health insurance while they search for jobs or begin Optional Practical Training (OPT).This transition period, which can vary from weeks to several months, often leaves graduates vulnerable to unexpected medical expenses. Since private insurance in the US is expensive, a source who studied at Rutgers University in New Jersey told India Today Digital that many go without coverage entirely during this time.It's only after securing employment that they gain access to employer-sponsored health schemes, which is often given after a three-month waiting period, the New Jersey-based source said.However, there was one way out.International students on F1 visas could purchase plans through the ACA Marketplace (Obamacare) if they are lawfully present in the US, though do not qualify for its subsidies.This safety net will not be available after the Big Beautiful Bill is fully enforced by 2027.INDIAN REFUGEES, LOW-INCOME GROUPS WILL HAVE NO SAFETY NET IN USA significant number of immigrants, particularly refugees and low-income groups directly depend on federal healthcare schemes.Data from the Organisation for Economic Co-operation and Development (OECD) suggest that asylum claims by Indian nationals increased from 6,000 in 2020 to 51,000 in 2023, an eightfold increase. For asylum seekers, reliance on Medicaid or emergency healthcare programmes is often their only option.While the latest law may reduce the number of undocumented immigrants, these restrictions may reshape perceptions of the US as a land of opportunity.But interestingly, Indian immigrants in the US have a seemingly decent record when it comes to health insurance.According to a November 2024 report by the Migration Policy Institute (MPI), Indians in the US had higher health insurance coverage rates compared to both the broader immigrant population and native-born Americans. The data revealed that in 2023, 4% of Indian immigrants were uninsured – a figure lower than the uninsured rates for the US-born population (6%) and the overall foreign-born population (18%).advertisementHowever, given that there are over 2 million Indian immigrants in the US, even a small percentage facing a lapse in coverage translates to tens of thousands left without a healthcare safety net. Estimates suggest that more than 80,000 Indians may fall into this vulnerable category. When fresh graduates – many of whom temporarily lose coverage after university – are added to this number, the figure would temporarily spike.The US has long grappled with some of the world's highest healthcare costs, where a single hospital stay can bankrupt families. Routine medical procedures carry price tags that would be unthinkable in other developed nations.Hence, access to healthcare and maintaining health insurance is a necessity in America.But there is still time before the full impact hits as the implementation of these policy changes is phased out, with some provisions, such as Medicaid work requirements, and Affordable Care Act subsidy restrictions, starting in January 2027.FEDERAL SUBSIDIES TO TAX CREDITS: WHAT THOUSANDS OF INDIANS WILL LOOSEUnder existing laws, legal immigrants, including Green Card holders, refugees, survivors of domestic violence, and those on work or student visas, have several ways to access healthcare coverage.advertisementGreen Card holders (permanent residents), refugees, survivors of domestic violence, and professionals (such as H-1B visa holders) or students (F-1 visa) can enrol in health insurance plans through the Affordable Care Act (ACA) marketplace, commonly known as Obamacare.The ACA platform allows individuals, families, and small businesses to compare and purchase health insurance policies.A key benefit of the ACA marketplace is the availability of premium tax credits (PTCs), which are federal subsidies designed to reduce monthly insurance costs for eligible enrollees. These credits make health coverage more affordable by lowering premium payments for qualified applicants.Certain immigrants qualify for Medicaid also – the joint state-federal programme that provides health coverage to low-income individuals. Eligibility for Medicaid varies by state.Additionally, immigrants aged 65 or older, or those with disabilities, become eligible for Medicare, the federal health insurance programme for seniors and certain disabled individuals. Medicare provides comprehensive coverage, though some beneficiaries may need to pay premiums for certain parts of the programme.Apart from this, many Indian immigrants, particularly H-1B professionals, rely on employer-sponsored insurance, which covers about half of all non-citizen immigrants, according to the Kaiser Family Foundation, a San Francisco-based non-profit organisation.advertisementMeanwhile, Indian students on F-1 visas typically pay between $1,500 and $2,500 annually for mandatory university health plans, as reported by the Institute of International Education.WHAT DOES ONE BIG BEAUTIFUL BILL CHANGE?The OBBB severely alters the existing provisions by narrowing eligibility for federal healthcare programmes.According to Politico, the bill restricts healthcare access primarily to Green Card holders, Cuban and Haitian immigrants, and select Pacific Island nationals.Two major changes stand out.First, Medicaid will impose an 80-hour monthly work, volunteer, or schooling requirement starting in 2027, along with biannual eligibility checks that could disrupt coverage for vulnerable groups.Second, the bill bars non-citizens, including visa holders, from receiving ACA subsidies, forcing many to shoulder higher insurance costs.Low-income families, including elderly parents and refugees, are also at risk of losing Medicaid coverage if they cannot meet the new work requirements.Professionals on H-1B visas who lack employer insurance, reportedly common among gig workers or contractors, may lose ACA subsidies, making coverage unaffordable.Students, already paying steep premiums for university plans, could face even fewer options.Speaking to India Today Digital, Suhas Pratap, an H-1B visa holder and a senior cloud architect at a major tech firm in New Jersey said, "My wife and I pay nearly $27,000 annually in taxes. Yet this bill would classify us as undeserving of the same safety nets our taxes help fund. Tech companies lobby for more H-1B visas, yet lawmakers want to deny us basic healthcare protections. My premium would jump from $450 to over $1,200 monthly without subsidies."advertisementThe Washington Post said the verification process itself creates hurdles: "The way it works right now, consumers can go to healthcare.gov and buy a subsidised plan But under the GOP changes, subsidies would be withheld until the state verifies eligibility."This delay could also leave many without coverage during emergency or critical periods.With full implementation of the healthcare laws looming less than two years away, they will certainly test whether the US remains a land of opportunity for millions of Indians who contribute billions to the American economy.- EndsTune In
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