Expedite Green Cards: 63 Lawmakers Press USCIS on Medicaid

Sixty-three members of Congress have asked USCIS to expedite green cards for lawfully present immigrants who are losing Medicaid and other federal health coverage while their adjustment of status applications wait for a decision. The letter, led by Democratic Reps. Yvette Clarke of New York and Adelita Grijalva of Arizona and addressed to USCIS Director Joseph Edlow, was made public Oct. 19, nearly three weeks after the health eligibility limits in the 2025 budget reconciliation law took effect.

The timing explains the urgency. Since Oct. 1, refugees, asylees and several other groups of lawfully present immigrants have generally lost federal Medicaid and CHIP eligibility unless they hold a green card, with narrow exceptions. Their immigration status did not change, but for many of them a pending Form I-485 now stands between them and coverage. The lawmakers argue that many of these people would be eligible as green card holders and are losing coverage only because their cases are stuck in processing.

The letter makes three requests. It asks USCIS to create an emergency expedited processing pathway for I-485 applicants facing an imminent loss of coverage, to state explicitly that losing federal or state health coverage counts as grounds for an expedite, and to work with the Centers for Medicare & Medicaid Services and state agencies on guidance that could delay coverage terminations for people with pending applications.

The lawmakers say more than 281,000 lawfully present immigrants in nine states and Washington, D.C., were identified as facing the loss of Medicaid beginning Oct. 1, and they cite a Congressional Budget Office estimate that 1.4 million lawfully present immigrants will become uninsured by 2034. Grijalva said more than 20,000 refugees and other lawfully present immigrants in Arizona are at risk.

An expedite moves a case up the line, not out of a hold

Part of what the letter seeks already exists on paper. The USCIS Policy Manual lets the agency expedite a case for severe financial loss, urgent humanitarian reasons, compelling U.S. government interests or clear USCIS error. Nothing in that list rules out a medical emergency, so an applicant about to lose coverage for cancer treatment can already ask under the humanitarian ground. The catch is in the same chapter: the decision is in USCIS’s “sole discretion,” the agency “is not required to provide justification” or even to respond, and it “generally requires documentation.” Written criteria naming coverage loss would make outcomes more predictable, which is the point of the second request.

The bigger obstacle for refugees is not their place in the queue. On Nov. 21, 2025, Edlow ordered a review of refugees admitted between Jan. 20, 2021, and Feb. 20, 2025, and put their pending green card applications on hold, according to the memo as reported by the Associated Press and CBS News. An expedite request asks USCIS to decide a case sooner; it does not lift a policy hold. For that group, a new pathway would change little unless USCIS also releases held cases.

USCIS figures show how much the hold matters. In the first nine months of fiscal 2026, the agency completed 3,805 refugee adjustment applications, down from 37,908 in the same period a year earlier, and refugee and asylee applications pending at the end of June totaled 275,737, according to an analysis of USCIS quarterly data by KFF, a nonpartisan health policy research organization. That pending count and the lawmakers’ 281,000 figure measure different groups and should not be read as the same people.

The administration has defended the review on security grounds. In the memo, Edlow wrote that the prior administration “prioritized expediency, quantity, and admissions over quality interviews and detailed screening and vetting,” CBS reported. That rationale makes a broad carve-out for refugees unlikely, and a faster track for the cases USCIS is not holding is the more realistic outcome if the agency acts at all.

What USCIS can and cannot do here

USCIS controls processing speed, not health eligibility. The coverage rules come from the 2025 statute and are run by CMS and the states, which is why the third request asks for coordination rather than a USCIS decision.

The next pressure point is Jan. 1, 2027, when Marketplace premium subsidies end for many of the same immigrants who lack a green card. If USCIS responds, the signal to watch is whether it rewrites its expedite criteria or only handles requests one by one. Its fourth-quarter fiscal 2026 data, covering July through September, will show whether refugee and asylee completions have begun to recover. This site covered the processing collapse behind the letter on Oct. 15.

This article is for general information and is not legal advice.

Sources

Vasanth Vaidyanathan, Esq.

Administrator

Vasanth Vaidyanathan is an immigration attorney with over 20 years of experience focused exclusively on U.S. immigration and nationality law. He holds a LL.M. from California Western School of Law, San Deigo and advises individuals and businesses on employment and family-based immigration matters, including H-1B, PERM, EB categories, and adjustment of status. He has also been a featured speaker at immigration seminars across the U.S. To reach Vasanth visit: https://www.vnathan.com/

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