Shutdown Deepens Over Medicaid, Immigration Dispute

The government shutdown entered its second day, furloughing hundreds of thousands of federal workers, closing offices and parks, and prompting White House warnings of further firings if no deal is reached. Republicans, including President Trump, have blamed Democrats, accusing them of demanding funding for free health care for undocumented immigrants, while Democrats say their core demands are extension of expiring ACA tax credits, reversal of Medicaid cuts and protections for already‑approved funding — measures that do not change federal prohibitions on Medicaid or ACA subsidies for unauthorized immigrants. A federal audit and state policies, notably in California, have shown instances of improper federal billing and raised questions about emergency Medicaid reimbursements for noncitizens, which opponents have seized on in the funding fight. At the same time, tightened visa rules, higher H‑1B fees, J‑1 processing delays and proposed Medicaid reductions, along with planned terminations of Temporary Protected Status for hundreds of thousands, risk worsening workforce shortages because immigrants make up a large share of clinicians and care workers. More than 100 lawmakers warned that TPS terminations combined with Medicaid cuts would create a “perfect storm” for the U.S. health system, intensifying staffing and access problems amid the shutdown fight.