On April 16, 2026, HHS Secretary Robert F. Kennedy Jr. testified before the House Committee on Education and the Workforce. When Rep. Greg Casar (D-TX) asked if he had met with any of the 1.4 million people who lost health insurance, Kennedy responded: “They're almost all illegal immigrants.”
This is false on multiple levels. Undocumented immigrants have never been eligible for ACA marketplace coverage — per HealthCare.gov itself, the Commonwealth Fund, and KFF. They cannot purchase ACA plans, cannot receive subsidies, and are ineligible for Medicaid (except emergency Medicaid in some states). The 1.4 million who dropped ACA coverage are American citizens and legal residents who could no longer afford it after Congress let enhanced premium subsidies expire on December 31, 2025.
CMS data shows ACA enrollment fell from 24.1 million (2025) to 22.8 million (2026). Average monthly premiums jumped from $113 to $178 (subsidized) — a 58% increase. The Urban Institute estimates 4.8 million total will lose coverage in 2026.
Kennedy may be deliberately conflating two separate populations. KFF analysis shows the 2025 Tax and Budget Law stripped ACA/Medicaid eligibility from 1.4 million lawfully present immigrants — refugees, asylees, TPS holders, and work visa holders. These are legal immigrants, not undocumented. Kennedy appears to be repackaging their coverage loss as an “illegal immigrant” talking point to deflect blame for premium increases that hit American citizens.
Casar concluded: “It sounds like he's met with nobody and been able to explain to them why it's okay that this policy kicks them off their healthcare.”