Rosa María Carranza attends a protest supporting the non permanent protected standing program exterior the Phillip Burton Federal Constructing and U.S. Courthouse in San Francisco on Nov. 18, 2025. Carranza, a resident of neighboring Oakland, worries she might lose her authorized standing and danger indefinite detention or deportation.
Hiram Alejandro Durán/El Tímpano
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Hiram Alejandro Durán/El Tímpano
OAKLAND, Calif. — Rosa María Carranza leaned ahead to carry a 3-year-old’s again because the lady climbed a rock within the forested hills of northeast Oakland.
Wearing mountain climbing gear and beaded necklaces, Carranza, 67, maneuvered between timber and kids on a sunny morning in December. “Maintain onto that department,” she stated in Spanish. “You are able to do it, my love!”
Carranza, a baby growth skilled who grew up swinging via timber and swimming in rivers in El Salvador, stated she feels at house within the forest on the out of doors preschool she co-founded. She has labored with kids and youths as a caregiver and educator for greater than three a long time, lengthy sufficient to know when to lean in and when to step again to let her college students discover their very own footing.
This text was produced in collaboration with El Tímpano.
When she transitioned to working part-time final 12 months, Carranza counted on getting Medicare and Social Safety checks — advantages given to American staff and lawfully current immigrants after they retire, in the event that they meet work historical past and age or incapacity necessities.
She’s contributed tens of hundreds of {dollars} into Medicare and Social Safety over 24 years, in response to her Social Safety Administration earnings document, reviewed by El Tímpano and KFF Well being Information. However Carranza and an estimated 100,000 different lawfully current immigrants will quickly be lower out of Medicare.
Rosa María Carranza encourages a toddler to navigate uneven floor at Joaquin Miller Park in Oakland, California, on Dec. 5, 2025. Carranza will lose Medicare when a federal coverage limiting well being care protection for some lawfully current immigrants takes impact subsequent 12 months.
Hiram Alejandro Durán/El Tímpano
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The GOP’s One Massive Stunning Invoice Act, signed final July by President Trump, barred sure classes of lawfully current immigrants — together with non permanent protected standing holders, refugees, asylum-seekers, survivors of home violence, trafficking victims, and folks with work visas — from Medicare.
These already in this system, like Carranza, might be disenrolled by Jan. 4 — a transfer by Republican lawmakers to rein in Medicare spending, as they and Trump have argued that taxpayer {dollars} shouldn’t be used to pay for the well being care of immigrants within the U.S. with out authorization.
“The Democrats need Unlawful Aliens, a lot of them VIOLENT CRIMINALS, to obtain FREE Healthcare,” Trump posted on Fact Social two months after he signed the invoice into regulation. “We can’t let this occur!”
Nonetheless the classes of immigrants now dropping protection do have authorized standing. Neither the White Home nor the Division of Well being and Human Providers responded to a query about whether or not it was honest to disenroll authorized residents from Medicare.
Undocumented immigrants have been already ineligible for Medicare or most different federally funded public advantages.
Carranza is apprehensive that she might additionally lose authorized permission to dwell in the US if the Trump administration ends non permanent protected standing for Salvadorans, because it sought to do throughout his first time period.
If that occurred, Carranza would lose authorized residency, risking time in an immigration detention middle or deportation.
“This is sort of a horror film, an entire nightmare,” Carranza stated. “This isn’t how I imagined getting previous.”
“Underneath fixed assault”
Carranza left El Salvador in 1991 throughout a brutal civil conflict, forsaking three younger kids, to earn cash to ship house to her household. She overstayed her visa till 2001, when she certified for non permanent protected standing, after two earthquakes struck El Salvador, killing greater than 1,100 individuals and displacing 1.3 million.
Non permanent protected standing, or TPS, was handed by Congress and signed into regulation by Republican President George H.W. Bush in 1990. It permits individuals similar to Carranza, from choose nations present process armed battle, civil conflict, and local weather disasters, to dwell and work in the US if being of their house nation poses a danger.
Carranza missed her youngest daughter’s commencement from kindergarten and first medal-winning efficiency in observe. She labored in a single day shifts babysitting newborns and later substitute-taught in public colleges within the San Francisco Bay Space to pay for her kids’s education in El Salvador, and for her personal courses at Metropolis School of San Francisco, the place she earned a level in youngster growth.
And she or he cared for dozens of 3-, 4-, and 5-year-olds who gazed in awe as they uncovered little treasures buried within the redwood forest of the Oakland park the place she co-founded Escuelita del Bosque, a Spanish immersion preschool that teaches kids outside.
The trade-off was imagined to be a peaceable retirement. However Congress narrowed Medicare eligibility to residents, lawful everlasting residents, Cuban and Haitian nationals, and folks lined below the Compacts of Free Affiliation, agreements between the US and Pacific island nations.
The transfer adopted Trump’s efforts to bar some immigrants with authorized standing from Medicaid, market insurance coverage subsidies, and social help companies, similar to meals help, housing subsidies, and medical visits in federally funded well being facilities. Altogether, 1.4 million lawfully current immigrants have been projected to lose medical insurance, in response to KFF, a well being info nonprofit that features KFF Well being Information.
A spokesperson for Home Speaker Mike Johnson, Taylor Haulsee, didn’t reply to requests for remark.
Michael Cannon, director of well being coverage research on the Cato Institute, a libertarian assume tank, stated Republicans needed to enact tax cuts and eradicate medical insurance for immigrants as a result of it would not upset their base.
“They do not wish to flip the US right into a welfare magnet,” he stated. “And so they resent the federal government for making them pay for a welfare state.”
Medicare information on lawfully current immigrants shouldn’t be out there. Nonetheless undocumented immigrants paid $6.4 billion into Medicare and $25.7 billion into Social Safety in 2022, in response to the Institute on Taxation and Financial Coverage. The Congressional Finances Workplace estimated that the Medicare restrictions alone would scale back federal spending by $5.1 billion by 2034.
Rosa María Carranza holds arms and sings with toddlers whereas they stroll alongside a path within the forested hills of northeast Oakland, California, on Dec. 5, 2025. Carranza co-founded Escuelita del Bosque, a Spanish immersion preschool at which kids spend a lot of their day studying and exploring exterior. (Hiram Alejandro Durán/El Tímpano)
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Shedding a lifeline
Well being specialists say eliminating protection for immigrants with authorized standing is unprecedented.
“That is truly the primary time that Congress has taken away Medicare from any group,” stated Drishti Pillai, director of immigrant well being coverage at KFF. “This modification is impacting immigrants who’ve lawful presence within the U.S., and lots of of whom have already labored and paid into the system for many years.”
As older adults like Carranza lose their Medicare protection, clinicians anticipate that they may delay their care, resulting in a rise in severely in poor health sufferers, particularly in hospital emergency rooms.
Seniors can develop into sick instantly and shortly, and they’re extra susceptible to cardiovascular ailments similar to coronary heart illness and hypertension, particularly in the event that they postpone routine care, stated Theresa Cheng, an emergency doctor at Zuckerberg San Francisco Common Hospital and assistant medical professor of emergency drugs on the College of California, San Francisco.
“It is fairly straightforward for them to fall off the cliff,” Cheng stated.
Carranza hikes, eats recent meals, and considers herself wholesome, however she acknowledges that she is getting old and beginning to battle to maintain up with the youngsters within the forest.
Late final 12 months she was recognized with hypertension, and in January she awakened with a decent chest and went to pressing care as a result of it had spiked to harmful ranges. Just a few weeks later, she tripped on a curb whereas strolling and fell to the bottom. She awakened the subsequent day with a swollen foot. A health care provider on the native hospital instructed her she had arthritis.
These have been scary moments, she stated, however she was grateful to must pay solely $10 for the pressing care go to and $5 to see her major care physician. Nonetheless, that can change when she loses Medicare by early subsequent 12 months.
The stress of realizing she is going to lose medical insurance protection, and doubtlessly her authorized standing, all whereas masked federal brokers are detaining immigrants like her throughout the nation, has taken a toll on her psychological well being, she stated. She is looking for a therapist and acupuncture companies to deal with her insomnia and nervousness — and the sensation that she is “below fixed assault.”
Nowhere to show
In California, house to the biggest variety of immigrant seniors, Carranza might have enrolled in state-sponsored insurance coverage, however this 12 months the state froze enrollment for adults 19 and older who’re a TPS holder, within the U.S. with out authorization, or an asylum-seeker. Different states with Democratic governors similar to Illinois and Minnesota have additionally scaled again their well being packages for immigrants amid price range pressures.
In January, California Gov. Gavin Newsom proposed a state price range that will not backfill federal well being care cuts to about 200,000 lawfully current immigrants, noting the $1.1 billion annual price ticket and state price range shortfalls.
“Given these fiscal pressures, the administration can’t backfill for this modification in federal coverage,” California Division of Finance spokesperson H.D. Palmer stated.
However some Democratic lawmakers and client advocates say the state ought to step in. State Meeting member Mia Bonta, who chairs the Meeting’s well being committee, stated she is engaged on a legislative price range resolution to carry immigrants who will lose well being protection, together with older adults, into Medi-Cal, the state’s model of Medicaid.
The East Bay Democrat is particularly involved for individuals like Carranza, “who’ve lived right here for many years and contributed into this financial system, who’ve given into our cultural cloth and into our communities and who constructed households and lives and who at the moment are wanting to have the ability to retire with dignity and dwell with dignity and have the well being care that they want.”
State and federal IDs belonging to Rosa María Carranza, together with Social Safety, driver’s license, and work authorization playing cards, are displayed on a desk at her house in Oakland, California, on Feb. 23, 2026. Carranza, who has lived and labored in the US for many years with non permanent protected standing, retains the playing cards as a document of her authorized authorization to work. (Hiram Alejandro Durán/El Tímpano)
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An indication of the long run
Final April, Carranza obtained a glimpse of what dropping her well being protection and retirement advantages might appear to be. The Social Safety Administration despatched her a letter informing her that she not certified for retirement advantages as a result of she was not lawfully current within the U.S. — regardless that she was. Then Medicare stopped funds to her well being plan, which disenrolled her in consequence.
As a TPS holder with a piece allow, she knew a mistake had been made. But, with out her verify, Carranza did not have cash to pay her lease for a month. She labored off her lease by babysitting her landlords’ kids. In Could, the workplace of U.S. Consultant Lateefah Simon, an Oakland Democrat, helped Carranza get better her retirement advantages, nevertheless it took months for her to get her medical insurance again.
The expertise left her reeling.
“It is like getting slapped on the face after greater than 30 years working for the system right here,” Carranza stated. “And in return, that is what we have now now.”
She lies awake at night time imagining the long run: right here, the place she’s spent half her life, with out medical insurance and probably Social Safety advantages; or in El Salvador, the place two of her three kids stay. Her daughter, a green-card holder who lives in Texas, hopes to develop into a citizen so she will be able to petition for everlasting residency for Carranza, however the course of can take years. Then there’s the chance she fears most: indefinite detention or deportation.
On a current morning in her basement studio in Oakland, Carranza pulled a field from the again of her closet. In it was a thick stack of identification playing cards that included previous driver’s licenses, her Social Safety card, and dozens of labor IDs issued by the federal authorities.
“My life is in that field,” she stated.
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF. This text was produced in collaboration with El Tímpano, a civic media group serving and masking the Bay Space’s Latino and Mayan immigrant communities.
