Editor’s note: This piece was first published by the Center on Budget and Policy Priorities (CBPP) on March 3, 2025 (updated on March 5, 2025) and is cross-posted with permission. It was written by Kiran Rachamallu, CBPP’s Research Assistant. CBPP is a member of the Coalition on Human Needs.

In addition to the numerous anti-immigrant actions the Trump Administration has already taken, congressional Republicans are considering legislative anti-immigrant proposals. The House and Senate have passed budget plans that call for supercharging funding to deport people throughout our communities. They also include cuts that would take away health coverage and nutrition assistance from people who face challenges affording these essential needs, including people who are immigrants.

The committees tasked with developing the legislation (called a “reconciliation” bill) are working from a House Republican list of options to produce savings. Some options would specifically harm families and children with low incomes and curtail access to health coverage, including an option that takes aim at state sovereignty when states choose to use their own resources for health coverage. Many of these same proposals were featured in the Republican Study Committee’s budget plan and the Heritage Foundation’s Project 2025 agenda.

Republican budget proposals would harm families and children by:

Reinstating the first Trump Administration’s harsh public charge policy. Under long-standing U.S. immigration law, certain individuals can be denied entry to the United States or permission to adjust their immigration status within the nation, if they are determined to likely become a “public charge.” For decades “public charge” has been defined as being primarily dependent on the government for subsistence, measured by receipt of cash assistance or receiving long-term institutional care (like nursing homes) paid for by the government.

The first Trump Administration’s public charge rule radically broadened this policy, effectively blocking people without substantial wealth (oftentimes those seeking lawful family-based immigration pathways) from being able to pass a public charge assessment. The policy was so extreme that about half of all U.S.-born citizens would likely be deemed a “public charge” if this definition were applied to them.

The rule also created mass confusion and fear that resulted in many people eligible for benefits in families that include immigrants going without key supports, such as health coverage and food assistance. Even though most people who will undergo a public charge assessment in the future do not qualify for public benefits, such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP), many people who are eligible for these benefits, such as U.S. citizen children, went without them if their families included someone who was an immigrant.

Even before the rule was finalized, about 1 in 5 adults in low-income immigrant families reported that they or a family member avoided non-cash government benefit programs because of concerns about public charge. When families forgo these benefits, the long-term health of our communities suffers. As just one example, studies have linked enrollment in benefits such as SNAP to improvements in health and reduced health care costs.

Taking away the Child Tax Credit from U.S. citizen children if their parents file federal taxes but do not have a Social Security number (SSN). Similar to the Trump Administration’s attempt to end birthright citizenship (an effort swiftly stopped in the courts), this tax policy targets U.S.-born children whose parents do not have specific types of immigration status. This will hurt children in our nation and, by extension, hurt our country’s future productivity. Research shows that children who benefit from credits like the Child Tax Credit experience stronger health, educational, and economic outcomes. Our tax policy should ensure all income-eligible families and children have access to the benefits of the Child Tax Credit, rather than discriminate against some children because of their parents’ immigration status.

Republican budget proposals would curtail access to health coverage by:

Taking away access to Medicaid and Affordable Care Act (ACA) marketplace coverage from people with lawful immigration statuses. There are already long-standing, harsh barriers to Medicaid coverage for many people with lawful immigration statuses. The Republican reconciliation options include even more restrictions to Medicaid eligibility.

The ACA was written to ensure that all people who have lawfully present immigration statuses in the U.S. can purchase coverage through ACA marketplaces. However, Republicans are seeking to restrict eligibility for certain people who are lawfully present — including, but not limited to, those with Deferred Action for Childhood Arrivals — in their budget-cutting options. It’s unclear which additional immigration statuses Republicans intend to exclude from eligibility to purchase health coverage in the ACA marketplaces.

Any proposals to further limit already restricted access to health coverage based on immigration status would result in poorer health outcomes, increased medical debt, and people delaying medical treatment.

Violating states’ sovereignty to use state funds to create a health program for people who are not eligible for federally funded Medicaid. Because of harsh federal immigration-related restrictions on access to Medicaid, 13 states and the District of Columbia have created state-only funded health programs with benefits similar to Medicaid. These state-funded programs serve some people who would qualify for Medicaid if not for the immigration requirements, including in some cases people without a documented immigration status. However, the House Republicans’ budget option list includes a provision to reduce federal Medicaid funding for states that provide these programs to people who do not have a documented immigration status, even though states use only their own state funds for these programs.

This proposal would seek to coerce states to refrain from lawful spending and raises serious constitutional concerns. The Supreme Court has long recognized that states’ sovereignty gives them control over how to spend their own funds, even if their priorities differ from those of the federal government. While the federal government has conditioned federal funding for programs on a state “match” of federal funds, this proposal is the opposite of a matching requirement. It would force states to forgo state-approved and lawful activities to receive federal funding for a separate program. This type of coercion is precisely what the Supreme Court has ruled violates the Tenth Amendment in cases such as NFIB vs. Sebelius.

There are 48 million immigrants currently residing in the United States. People who are immigrants and their families are our neighbors, co-workers, and classmates, serving as vital parts of our communities and economy. They work in a wide variety of jobs, including as 37 percent of construction laborers, 16 percent of registered nurses, and 46 percent of software developers, generating $4.6 trillion in economic output in 2022. Instead of pursuing policies of exclusion that would increase poverty and hardship, policymakers should create an inclusive society where everyone, regardless of immigration status, can thrive.