S2149-119

In Committee

Health Equity and Access under the Law for Immigrant Families Act of 2025

119th Congress Introduced Jun 24, 2025

Summary

What This Bill Does

The bill exempts statement of purpose declaring intent to ensure health program eligibility for lawfully present individuals, enable undocumented individuals to access ACA exchanges, eliminate state authority to restrict, requires medicaid and CHIP eligibility requirements under Social Security Act sections 1903(v)(4) and 2107(e)(1), mandating states provide medical assistance to lawfully residing individuals including those, and exempts eligibility expansion for individuals with Federally authorized presence (including deferred action) across ACA exchanges, cost-sharing reductions, premium subsidies, and Medicaid/CHIP, with special enrollment. It relies on definition changes, exemptions, compliance mandates, and tax credits. The main policy areas are Civil Rights, Healthcare, and Finance.

Who Benefits and How

Noncitizen individuals ineligible for Medicaid due to immigration status could see lower costs, Lawfully residing immigrants and deferred action recipients could see lower costs, and Lawfully present immigrants including deferred action recipients could see lower costs.

Who Bears the Burden and How

State Medicaid programs would take on compliance duties, Federal Medicaid program could face higher costs, and Medicare program (Parts A and B) could face higher costs.

Key Provisions

  • Exempts statement of purpose declaring intent to ensure health program eligibility for lawfully present individuals, enable undocumented individuals to access ACA exchanges, eliminate state authority to restrict...
  • Requires medicaid and CHIP eligibility requirements under Social Security Act sections 1903(v)(4) and 2107(e)(1), mandating states provide medical assistance to lawfully residing individuals including those...
  • Exempts eligibility expansion for individuals with Federally authorized presence (including deferred action) across ACA exchanges, cost-sharing reductions, premium subsidies, and Medicaid/CHIP, with special enrollment...
  • Creates removal of citizenship and immigration status barriers from ACA premium tax credits (IRC 36B), cost-sharing reductions, basic health program eligibility, federal payment restrictions, and minimum essential...
  • Defines savings clause preserving existing ACA premium tax credit eligibility for lawfully present noncitizens ineligible for full Medicaid benefits, with definition of full benefits as comprehensive state Medicaid plan...

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

The bill exempts statement of purpose declaring intent to ensure health program eligibility for lawfully present individuals, enable undocumented individuals to access ACA exchanges, eliminate state authority to restrict, requires medicaid and CHIP eligibility requirements under Social Security Act sections 1903(v)(4) and 2107(e)(1), mandating states provide medical assistance to lawfully residing individuals including those, and exempts eligibility expansion for individuals with Federally authorized presence (including deferred action) across ACA exchanges, cost-sharing reductions, premium subsidies, and Medicaid/CHIP, with special enrollment.

Key Policy Areas

Civil Rights, Healthcare, Finance

Primary Purpose

The bill exempts statement of purpose declaring intent to ensure health program eligibility for lawfully present individuals, enable undocumented individuals to access ACA exchanges, eliminate state authority to restrict, requires medicaid and CHIP eligibility requirements under Social Security Act sections 1903(v)(4) and 2107(e)(1), mandating states provide medical assistance to lawfully residing individuals including those, and exempts eligibility expansion for individuals with Federally authorized presence (including deferred action) across ACA exchanges, cost-sharing reductions, premium subsidies, and Medicaid/CHIP, with special enrollment.

Policy Domains

Civil Rights Healthcare Finance

Sec. 3 -- Removing Barriers to Health Coverage for Lawfully Residing Individuals

Identified Gains
  • Noncitizen individuals ineligible for Medicaid due to immigration status
  • Lawfully residing immigrants and deferred action recipients
  • Lawfully present immigrants including deferred action recipients
  • Deferred action recipients and federally authorized presence holders
  • Lawfully present immigrants
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: is
Lawfully present immigrants:
Lawfully residing immigrants and deferred action recipients:
Lawfully present immigrants including deferred action recipients:
Deferred action recipients and federally authorized presence holders:
Noncitizen individuals ineligible for Medicaid due to immigration status:
Identified Costs
  • State Medicaid programs
  • Federal Medicaid program
  • Medicare program (Parts A and B)
  • Federal Treasury (premium subsidy outlays)
  • Federal government health programs
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: is
State Medicaid programs:
Federal Medicaid program:
Medicare program (Parts A and B):
Federal government health programs:
Federal Treasury (premium subsidy outlays):

Legislative Progress

In Committee
Introduced Committee Passed
Jun 24, 2025

Mr. Booker (for himself, Mr. Heinrich, Mr. Padilla, Ms. Warren, …

Jun 24, 2025

Read twice and referred to the Committee on Finance.

Jun 24, 2025

Introduced in Senate

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

Immigrant Communities
9 mentions across 6 clauses
+9 positive

Deferred action recipients and federally authorized presence holders, Immigrant sponsors, Lawfully present immigrants

Government
6 mentions across 5 clauses
-6 negative

Federal Medicaid program, Federal Treasury (premium subsidy outlays), Federal government (subsidy costs)

Financial Services
2 mentions across 2 clauses
+2 positive

ACA marketplace plans, Health insurance exchanges

Health Care Providers
1 mention across 1 clause
+1 positive

Healthcare providers serving immigrant populations

7/9
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Civil Rights Healthcare Finance
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
Domains
Healthcare
Actor Mappings
"the_secretary"
→ Secretary of Health and Human Services
Domains
Healthcare Tax
Domains
Healthcare
Domains
Healthcare

Key Definitions

Terms defined in this bill

3 terms
"Federally authorized presence" §4(a)

Individuals granted Federally authorized presence in the United States, considered lawfully present for purposes of health coverage eligibility.

"full benefits" §7(b)

Medical assistance for all services covered under the State Medicaid plan that is not less in amount, duration, or scope than assistance available for categorically eligible individuals.

"lawfully present" §8(c)

Includes at minimum all immigration categories treated as lawfully present for purposes of Medicaid as amended by section 3.

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