No Federal Tax Dollars for Illegal Aliens Health Insurance Act of 2026
Summary
What This Bill Does
The No Federal Tax Dollars for Illegal Aliens Health Insurance Act changes Affordable Care Act section 1332 state-innovation waivers. Current law allows states to request waivers of requirements in Part B of the ACA's exchange provisions. The bill excludes section 1312(f)(3), which limits exchange qualified-plan enrollment to U.S. citizens, U.S. nationals, and lawfully present immigrants, from that waiver authority.
The bill also limits federal pass-through funding paid to a state implementing a section 1332 waiver. None of that money may offset premiums or cost sharing, or provide another benefit, for a person who is neither a U.S. citizen or national nor lawfully present. The restriction follows the federal dollars rather than prohibiting a state from using its own money for separate coverage.
Within 30 days after enactment, HHS must rescind any existing section 1332 waiver that would not have been approved under the new rules. This can reach waivers that permit people without federally recognized lawful status to buy coverage through a state exchange even when they receive no federal premium tax credit, because the lawful-presence enrollment rule itself becomes nonwaivable.
The bill does not bar health coverage for lawfully present immigrants, prohibit all private off-exchange purchases, alter emergency-care duties, change Medicaid eligibility directly, or prevent a state from creating a state-funded program outside the conflicting federal waiver.
Who Benefits and How
Federal taxpayers and lawmakers favoring immigration-linked benefit restrictions gain a categorical rule against federal waiver funds benefiting people without lawful status. Citizens, nationals, and lawfully present enrollees remain eligible under ordinary rules. HHS gains a clear statutory limit for future waiver review.
Who Bears the Burden and How
People without federally recognized lawful status can lose exchange access created by a waiver and may face higher premiums or uninsurance. States with affected waivers must redesign exchange and subsidy programs rapidly. State-funded programs may bear more cost, insurers may lose enrollment, and HHS must identify and rescind conflicting approvals within 30 days.
Key Provisions
- Makes the ACA lawful-presence enrollment rule nonwaivable.
- Preserves waiver authority for other eligible Part B requirements.
- Prohibits pass-through premium support for ineligible individuals.
- Prohibits pass-through cost-sharing support for ineligible individuals.
- Prohibits other pass-through-funded benefits for ineligible individuals.
- Requires rescission of conflicting existing waivers.
- Sets a 30-day rescission deadline.
- Preserves coverage eligibility for lawfully present immigrants.
- Leaves state-only funding authority outside the federal restriction.
- Leaves private off-exchange coverage and emergency care unchanged.
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
Makes the Affordable Care Act's lawful-presence restriction nonwaivable under section 1332, prohibits federal waiver pass-through funds from subsidizing coverage or other benefits for people who are neither U.S. citizens or nationals nor lawfully present, and requires rescission of conflicting waivers within 30 days.
Key Policy Areas
Affordable Care Act Waivers, Immigrant Health Coverage, Federal Health Subsidies, State Insurance Exchanges, HHS Waiver Administration
Primary Purpose
Makes the Affordable Care Act's lawful-presence restriction nonwaivable under section 1332, prohibits federal waiver pass-through funds from subsidizing coverage or other benefits for people who are neither U.S. citizens or nationals nor lawfully present, and requires rescission of conflicting waivers within 30 days.
Policy Domains
Sections 1 and 2 short title, nonwaivable lawful-presence rule, pass-through restriction, and waiver rescission
Identified Gains
- Federal taxpayers opposing unauthorized benefits
- Citizens eligible for exchange coverage
- United States nationals eligible for exchange coverage
- Lawfully present exchange enrollees
- HHS waiver-review officials
- Immigration-status verification programs
Identified Costs
- People lacking federally recognized lawful status
- Families losing affected exchange access
- States operating inclusive exchange waivers
- State-funded immigrant coverage programs
- Insurers serving affected waiver markets
- HHS waiver-rescission staff
- State exchange technology administrators
- Health clinics serving newly uninsured patients
Sponsors
Legislative Progress
In CommitteeReferred to the Committee on Energy and Commerce, and in …
Introduced in House
Ms. Boebert (for herself, Mr. Hurd of Colorado, Mr. Crank, …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Citizens eligible for exchange coverage, Exchange health insurers, Families losing affected exchange access
HHS waiver-rescission staff, HHS waiver-review officials, Immigration-status verification programs
Positive-direction: Immigration-status verification programs
Negative-direction: HHS waiver-rescission staff
State exchange technology administrators, State health-waiver administrators, State-funded immigrant coverage programs
Federal taxpayers opposing unauthorized benefits
Health clinics serving newly uninsured patients
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "insurer"
- → Carrier serving an affected state exchange
- "enrollee"
- → Citizen, national, or lawfully present exchange participant
- "resident"
- → Person seeking coverage without federally recognized lawful status
- "applicant"
- → State seeking or operating a section 1332 waiver
- "secretary"
- → HHS Secretary approving or rescinding a waiver
Note: {'scope_ids': ['aca_waiver_lawful_presence_limit'], 'description': 'The bill restricts federal waiver authority and pass-through funds, not every state-funded or private coverage arrangement; it protects lawfully present immigrants but can rescind waivers that merely open state exchanges to other residents without granting them federal tax credits.'}
Key Definitions
Terms defined in this bill
A pre-enactment section 1332 approval that could not have been approved if the new lawful-presence and federal-funding restrictions had applied.
The ACA rule limiting qualified individual-market exchange enrollment to citizens, nationals, and lawfully present immigrants.
Federal amounts reflecting credits or cost-sharing reductions that would otherwise have been paid and are instead sent to a state to implement its waiver plan.
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.
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