A newly released White House memorandum has outlined the financial impact of provisions contained in the Democrats’ proposed continuing resolution (CR), revealing that the plan would repeal major healthcare reforms signed into law by President Donald Trump.
The memo concludes [1] that if enacted, the proposal would direct nearly $200 billion over the next decade toward healthcare for illegal immigrants and other non-citizens, while eliminating multiple safeguards designed to prioritize American citizens.
The reforms at issue were enacted under the Working Families Tax Cut Act (WFTCA), which was signed into law by President Trump.
The law redirected taxpayer resources by closing loopholes and strengthening eligibility requirements to ensure healthcare benefits were reserved for American citizens. Among its key provisions, the law:
- Ended Medicaid and Medicare funding for most non-citizens.
- Blocked the use of emergency Medicaid expansions that reimbursed hospitals at higher rates for treating illegal immigrants than for caring for American seniors and children.
- Repealed an Affordable Care Act subsidy rule that provided benefits to immigrants earning below the poverty line, while poor American citizens were ineligible.
- Shut down a California program that used federal funds to provide Medicaid benefits to illegal immigrants.
- Expanded Health Savings Accounts to approximately 10 million Americans.
According to the White House memo, the Democrats’ proposal would reverse those reforms.
The projected costs include:
- $91.4 billion to restore Affordable Care Act subsidies for non-citizens.
- $34.6 billion to reopen California’s Medicaid program for illegal immigrants.
- $28.2 billion in emergency care reimbursements for non-citizens.
- $27.3 billion in subsidies under the repealed Affordable Care Act “special rule.”
- $6.2 billion in new Medicaid expenditures for non-citizens.
- $5.1 billion in Medicare costs for non-citizens.
In total, the plan would spend $192.8 billion over the next 10 years on healthcare for illegal immigrants and other non-citizens, nearly equal to the funding required for the Children’s Health Insurance Program (CHIP) for the same time period.
The memo also states that the Democrat plan would repeal anti-fraud measures and remove work requirements for able-bodied adults, while canceling a $50 billion Trump-era investment in rural healthcare infrastructure.
White House officials have pointed to the proposal as the central reason for the current government shutdown.
Vice President J.D. Vance emphasized that the issue is not a matter of political spin but of legislative text.
“It’s not something that we made up. It’s not a talking point. It is in the text of the bill that they initially gave to us to reopen the government,” Vance said.
.@VP [2] nukes the Democrat lie that they aren’t trying to give free health care to illegals:
“It’s not something that we made up. It’s not a talking point. It is in the text of the bill that they initially gave to us to reopen the government.” pic.twitter.com/regw9fGH1i [3]
— Rapid Response 47 (@RapidResponse47) October 1, 2025 [4]
The memo further details the effects of the Democrats’ proposal, stating:
- Non-citizens granted asylum or parole under Biden administration policies would again become eligible for Medicaid.
- Medicaid reimbursements for emergency care to illegal immigrants would be greater than for American citizens who are elderly, disabled, or children.
- California’s loophole allowing federal funds to cover Medicaid benefits for illegal immigrants would be reinstated.
- A special Affordable Care Act subsidy program for non-citizens, previously repealed, would be restored.
- Ten million American citizens would lose expanded Health Savings Accounts created under the WFTCA.
The White House framed the memo as a direct rebuttal to claims from Democratic leaders that Republicans were spreading misinformation about the contents of the CR.
Officials noted that the financial impact and eligibility expansions are clearly written in the legislation.
The continuing standoff in Congress has kept the government closed as negotiations continue.
The White House says it will continue to push for the preservation of Trump-era reforms, citing both the cost to taxpayers and the potential impact on American citizens if the safeguards are repealed.