Dear Delaware,

On Thursday, October 1, federal Medicaid rules change in this state. Delaware’s Department of Health and Social Services says it plainly: if you are not a U.S. citizen, your coverage could end because of a new federal law (DHSS Medicaid ENGAGE).

I spent years as a travel ICU nurse. Coverage is not paperwork. Coverage is whether someone can fill a prescription, get a follow-up, or reach a clinic before the ER is the only door left.

Starting October 1, noncitizens generally need a short set of statuses for full Medicaid: a lawful permanent resident who has cleared the five-year wait or is exempt from it; a Cuban or Haitian entrant; or a COFA migrant from the Marshall Islands, Micronesia, or Palau. Pregnant women and children can still qualify under Delaware’s CHIPRA 214 option. Refugees may get full coverage for only the first four months of refugee status — then they drop to emergency and labor-and-delivery services unless they hold a qualifying status (DHSS Medicaid ENGAGE).

Delaware’s own guidance says you will no longer qualify for full Medicaid after October 1 if you are, among others: an asylee; a refugee past that four-month window; a parolee — including certain Afghan and Ukrainian parolees; a VAWA petitioner who has been battered or subjected to extreme cruelty; a trafficking victim and certain family members; or a noncitizen honorably discharged veteran, an active-duty service member, and their spouse or unmarried dependent children (DHSS Medicaid ENGAGE).

Sit with that. People who fled violence. People Congress brought here under parole. Noncitizen veterans who wore the uniform. That is not a paperwork glitch. That is a choice about whose body gets care.

People who lose full coverage may still get Emergency Medicaid — but only for labor and delivery, or a sudden life-threatening situation or severe acute illness or injury, and only in a hospital ER, acute inpatient hospital, or birthing center (DHSS Medicaid ENGAGE). That is a crash cart, not a health system.

KFF’s September analysis — citing the Congressional Budget Office — says the 2025 reconciliation law’s Medicaid and CHIP immigrant-eligibility cuts take effect October 1 and will reduce federal spending by $6.2 billion and leave an additional 100,000 people uninsured by 2034 (KFF). That is a national CBO score, not a Delaware headcount. I will not invent one. The state’s warning is enough: coverage can end Thursday, and someone else in your household can lose coverage even if yours holds.

This is the same ledger Delaware already saw last week, when the state announced nearly $23 million for federally qualified health centers — Westside, La Red, Henrietta Johnson — while bracing for Medicaid reductions (Spotlight Delaware; delaware-fqhc-awards-medicaid-cuts). Clinics get a modernization check. Patients get a narrower door.

October 1 is not the whole bill. Starting January 1, 2027, adults in Delaware’s Medicaid Expansion group face federal work and community-engagement rules — earn at least $580 a month or complete at least 80 hours a month, with renewals every six months (DHSS Medicaid ENGAGE). That clock is next. Thursday comes first.

Health care is a right — expanding coverage, capping prescription costs, ending medical debt, restoring Marketplace premium help, with the rich paying their fair share. Universal care means everyone — not everyone except the refugee past month four, the asylee, the parolee, the trafficking survivor, or the veteran who is not a citizen. Congress should reverse these eligibility cuts and protect Medicaid.

This campaign is people-funded. No Super PAC. Ever.

The Delaware Department of Elections lists me as a Qualified write-in candidate. My name is not printed on the ballot. If you are not registered yet, the deadline is Saturday, October 10. Thirty-four days from now, on November 3, write TRAVIS JACK STEVENS for U.S. Senate.

With gratitude and determination,

Travis Jack Stevens
Write-in candidate for U.S. Senate · Delaware
travisjackstevens.com