As Congress votes again on a bill that would essentially re-open the government, there have been a lot of statements—of widely varying accuracy—about who exactly would benefit from calls to repeal the health cuts in H.R. 1 (formerly the One Big Beautiful Bill Act) and/or extend the enhanced Advanced Premium Tax Credits (APTCs) which expire next month. The American public is understandably confused; for example, less than half understand that undocumented immigrants are not eligible for Marketplace coverage. So, let’s review the accuracy of three statements being repeated by many politicians and pundits.
Statement #1 – “The effort to repeal health cuts in H.R. 1 and/or extend enhanced APTCs is primarily about providing coverage to undocumented immigrants.”
This statement is false.
As we have previously explained, since undocumented immigrants are not generally eligible for Medicaid, Medicare, or the Marketplace APTCs, they are not impacted by the H.R. 1 cuts or their reversal, nor the extension or non-extension of enhanced APTCs. Not only is coverage for undocumented immigrants not the main purpose of these policies, it’s not even impacted.
Statement #2 – “The effort to repeal health cuts in H.R. 1 and/or extend enhanced APTCs is primarily about providing coverage to lawfully present immigrants.”
This statement is false. However, while restoring coverage for lawfully present immigrants such as refugees is not the primary impact of repealing H.R. 1 health cuts and extending enhanced APTCs, it is at least one of the secondary impacts. But how, you might ask, do I assess the primary impact of these policies? Here’s how.
The Congressional Budget Office (CBO) estimates that there will be 10 million more people who are uninsured in 2034 under H.R. 1. Per the estimate, 1.4 million are the result of cuts taking away lawfully present immigrants’ eligibility for Medicaid, Medicare, and Marketplaces. The rest of the coverage losses are due to broad cuts to the programs (most in Medicaid) that are not targeted at immigrants. Meanwhile, in June 2025, just before H.R. 1 was signed into law, the CBO similarly estimated that not extending APTCs, which also has broad impacts, will result in 4.2 million people losing health insurance.
Between them, the two CBO estimates predict 14.2 million people will lose coverage, and of them, only 1.4 million—just under 10%—will be because of policies targeting lawfully present immigrants. As such, protecting coverage for lawfully present immigrants could fairly be characterized as a minor or secondary impact of reversing H.R. 1 health cuts and extending enhanced APTCs, but it is clearly not the overarching aim or impact.
Statement #3 – “The effort to repeal health cuts in H.R. 1 and/or extend enhanced APTCs is primarily about providing coverage to U.S. citizens.”
This statement is true. The predominant impact of reversing H.R. 1 health care cuts and extending enhanced APTCs is to protect coverage for U.S. citizens.
Based on the CBO estimates above, something like 90% of the coverage loss—around 12.8 million people—will be the result of broad cuts to the health care programs that U.S. citizens rely upon. The overwhelming majority of people losing Medicaid, Medicare, and Marketplace coverage under H.R. 1 and non-extension of APTC enhancements will be U.S. citizens. As such, efforts to repeal H.R. 1 health care cuts or extend enhanced APTCs can be fairly characterized as primarily about protecting coverage for U.S. citizens.