HR584-119

In Committee

No Medicaid for Illegal Immigrants Act of 2025

119th Congress Introduced Jan 21, 2025

Summary

What This Bill Does

The No Medicaid for Illegal Immigrants Act amends Social Security Act section 1902(a), which sets State Medicaid plan requirements. It adds a new requirement that, notwithstanding section 1903(v)(4), a State plan or waiver may not make medical assistance available to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law. The exception preserves assistance for which federal payment is available under section 1903(v)(2), the emergency medical assistance provision. In practical terms, the bill narrows State flexibility to use Medicaid plans or waivers for non-emergency coverage of covered non-lawfully-present individuals while preserving emergency Medicaid payment rules.

Who Benefits and How

Federal Medicaid budget hawks benefit because the bill blocks non-emergency Medicaid assistance for the covered immigrant category. State Medicaid agencies seeking a uniform federal restriction benefit from a clear plan requirement. Emergency Medicaid providers benefit because the section 1903(v)(2) emergency-assistance exception is preserved. Taxpayers opposed to non-emergency Medicaid coverage for undocumented immigrants benefit from a statutory spending restriction.

Who Bears the Burden and How

Undocumented immigrants seeking non-emergency Medicaid coverage bear the direct burden because State plans and waivers could not make that assistance available. State Medicaid eligibility workers must apply the new lawful-permanent-residence or PRUCOL-based exclusion. CMS Medicaid plan reviewers must review State plan and waiver compliance with the new requirement. Safety-net hospitals and clinics may face more uncompensated non-emergency care when affected patients lose Medicaid payment pathways.

Key Provisions

  • Amends Social Security Act section 1902(a) to add a Medicaid plan requirement.
  • Prohibits non-emergency medical assistance for aliens not lawfully admitted for permanent residence or permanently residing under color of law.
  • Preserves emergency assistance payable under section 1903(v)(2).
  • Applies the restriction to State Medicaid plans and waivers.

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

Requires State Medicaid plans and waivers to deny medical assistance to aliens who are not lawful permanent residents or otherwise permanently residing in the United States under color of law, except for emergency assistance payable under Social Security Act section 1903(v)(2).

Key Policy Areas

Medicaid, Immigration, Health Care

Primary Purpose

Requires State Medicaid plans and waivers to deny medical assistance to aliens who are not lawful permanent residents or otherwise permanently residing in the United States under color of law, except for emergency assistance payable under Social Security Act section 1903(v)(2).

Policy Domains

Medicaid Immigration Health Care

Substantive provisions

Identified Gains
  • Federal Medicaid budget hawks
  • State Medicaid agencies
  • Emergency Medicaid providers
  • Taxpayers opposed to non-emergency coverage
Model: codex-gpt-5 | Version: bill_summary_v2 | Source: ih
State Medicaid agencies:
Emergency Medicaid providers:
Federal Medicaid budget hawks:
Taxpayers opposed to non-emergency coverage:
Identified Costs
  • Undocumented immigrants seeking Medicaid coverage
  • State Medicaid eligibility workers
  • CMS Medicaid plan reviewers
  • Safety-net hospitals
Model: codex-gpt-5 | Version: bill_summary_v2 | Source: ih
Safety-net hospitals:
CMS Medicaid plan reviewers:
State Medicaid eligibility workers:
Undocumented immigrants seeking Medicaid coverage:

Legislative Progress

In Committee
Introduced Committee Passed
Jan 21, 2025

Mr. Kiley of California introduced the following bill; which was …

Jan 21, 2025

Referred to the House Committee on Energy and Commerce.

Jan 21, 2025

Introduced in House

Impact analysis is available but no clear stakeholder effects identified. View clause-level analysis →

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Medicaid Immigration Health Care

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology