Federal law is changing who qualifies for NJ FamilyCare. Beginning October 1, 2026, many lawfully present immigrants may lose their coverage. Congress passed the One Big Beautiful Bill Act, which President Trump signed into law in 2025. Among its many provisions is a significant restriction on Medicaid eligibility for non-citizen immigrants. Starting October 1, 2026, certain lawfully present immigrants who are currently enrolled in NJ FamilyCare — New Jersey's name for its Medicaid program — may no longer qualify.
This is not a future concern. NJ has already begun mailing letters to potentially affected members to gather information and assess eligibility before the October 1 deadline. If you or someone you know receives one of these letters, the worst thing to do is ignore it.
Who Is Affected
The changes target a specific set of immigration categories. The following groups of lawfully present non-citizens may lose NJ FamilyCare coverage on October 1, 2026:
- Refugees;
- Asylees;
- Certified victims of trafficking and their spouse, child, sibling, or parents;
- Veterans or active-duty military and spouses or unmarried dependents who also have qualified non-citizen status;
- Iraqi and Afghani parolees;
- Individuals who were paroled into the U.S. between February 24, 2022 and September 30, 2024 under the Ukrainian Humanitarian Parole (UHP) program; and
- People whose deportation is being withheld.
What these categories share is that they represent people who entered the United States through humanitarian or protection-based pathways — people who, in many cases, fled violence or persecution. Under existing rules, federal law treated many of them as eligible for Medicaid. The new law removes that eligibility for those who have not taken a specific additional step: transitioning to Lawful Permanent Resident (LPR) status.
The Green Card Exception
Adjusting to LPR status — becoming a permanent resident with a green card — does not automatically solve the problem. The law imposes a five-year waiting period. If you transitioned to LPR status less than five years ago, you may still be ineligible. The five-year clock runs from the date the immigrant obtains qualified alien status.
There are, however, carve-outs to the five-year rule. If you originally arrived in one of the affected categories and you have since transitioned to LPR status, you may still qualify even if it has been less than five years. These categories include:
- Refugees;
- Asylees;
- Certified victims of trafficking and their spouse, child, sibling, or parents;
- Veterans or active-duty military and spouses or unmarried dependents who also have qualified non-citizen status;
- Amerasian immigrants;
- Iraqi and Afghani special immigrants and parolees;
- Individuals who were paroled into the U.S. between February 24, 2022 and September 30, 2024 under the Ukrainian Humanitarian Parole (UHP) program; and
- People whose deportation is being withheld.
The state has been directed to treat those individuals more favorably than others in the LPR-under-five-years category.
If that sounds complicated, it is. The intersection of immigration status and Medicaid eligibility has never been simple, and the new law adds another layer of complexity. If you are uncertain whether these changes apply to you, do not try to figure it out alone.
Who Is Not Affected
Not every non-citizen is at risk. In addition to the categories noted above, several groups will continue to qualify under the new rules including:
- Lawful Permanent Residents of at least 5 years (calculated from date on green card);
- Lawfully present non-citizens who are pregnant, or under the age of 21;
- Cuban/Haitian Entrants;
- Compact of Free Association (COFA) migrants, including individuals from Micronesia, Marshall Islands, and Palau; and
- Children under 19, regardless of their immigration status.
These populations are protected by separate statutory provisions and should not see a change in their eligibility on October 1.
What New Jersey Is Already Doing
NJ FamilyCare is not waiting until October. The state has begun sending outreach letters to members whose immigration status may bring them within the affected categories. These letters are not yet termination notices — they are requests for information to help the state determine who remains eligible and who does not.
If NJ FamilyCare already has what it needs to confirm your continued eligibility, you will receive a letter telling you your coverage has been renewed. If it needs more, you will receive a request for documentation or a renewal packet. The critical thing is to respond promptly. Failing to respond can result in a gap or termination of coverage, even if you are actually still eligible.
Members should also make sure their contact information is current. If your address or phone number has changed, call NJ FamilyCare Customer Service at 1-800-701-0710 (TTY: 711) now, before any letter goes undelivered.
The Broader Picture
These changes do not exist in isolation. The same legislation that is cutting Medicaid eligibility for immigrants also introduces work and community engagement requirements for certain adult enrollees beginning January 1, 2027, and shortens the renewal period from annually to every six months for those in certain plans. The cumulative effect of these changes is a significant increase in administrative burden on the states and more paperwork for some of the most vulnerable Medicaid enrollees in the state.
New Jersey has historically taken steps to extend coverage to immigrant populations beyond what federal law requires but those programs cost money. Whether New Jersey will maintain state funded coverage options is an open question.
Learn More
For a detailed explanation of how immigration status affects NJ Medicaid eligibility under existing rules, see our guide: NJ Medicaid and Immigration Status — What You Need to Know.
For a broader overview of the federal Medicaid cuts in the One Big Beautiful Bill Act affecting New Jersey residents, see: Federal Medicaid Cuts: What New Jersey Residents Need to Know.
The official NJ DMAHS information page on these changes is available at nj.gov/humanservices/dmahs/obbba/medicaid-federal-changes.shtml. The state has indicated it will update that page as additional guidance becomes available.