Thousands of refugees and other legal immigrants across the country are set to lose access to Medicaid starting Thursday as Republican-led cuts to the health insurance program for low-income people take effect. Some of those immigrants who depend on Medicaid said in interviews that they were not sure how they would afford to treat their conditions, such as kidney failure, multiple sclerosis and bipolar disorder. Several said they applied for permanent residency more than a year ago, a status that would allow them to keep their coverage. But they said they have yet to hear back from U.S. Citizenship and Immigration Services amid slowdowns in green card processing.

States across the country have warned recently that the thousands who will lose coverage include refugees, people granted asylum, people granted parole and certain victims of domestic violence. The nonpartisan Congressional Budget Office estimated that the changes would lead to roughly 100,000 more people becoming uninsured. Immigrant advocates say many of those people would instead be forced to turn to emergency rooms for care. The cuts represent a major shift for many legal immigrants who have had access to Medicaid for decades.

“Fundamentally, it’s a change in how we view people who come to the country and, specifically in this case, the humanitarian population,” said Valerie Lacarte, a senior policy analyst at the Migration Policy Institute. The decision to make these immigrants ineligible for the program was approved by Congress last year as part of President Trump’s domestic policy bill, which enacted tax cuts and sweeping restrictions on immigrants’ use of safety net programs.

Farahzad Sediqi, 32, said she was set to lose Medicaid, which helps cover her treatment for multiple sclerosis. Ms. Sediqi fled Afghanistan and arrived as a refugee in May 2023. Her mother, Amina Safawi, who also relies on Medicaid to treat back pain and diabetes, said she cannot afford her daughter’s neurologist appointments or home care nurses.