Excluding Illegal Aliens from Medicaid Act

This bill would speed up a change to Medicaid rules about noncitizen eligibility and tighten federal funding rules for states that use their own money to cover certain noncitizens. It moves the start date for a prior change in Medicaid eligibility for noncitizens from October 1, 2026, to July 4, 2025. It also updates how federal Medicaid expansion funds are handled for any state that, during a quarter, uses state funds to buy health insurance or provide broad health coverage for people who are not “qualified” under federal immigration law (this does not include lawfully residing children or pregnant women eligible under existing exceptions, and it excludes coverage required by federal law). These states are labeled “specified States,” and the bill shifts related funding calculations to be done quarter by quarter .

Key points

• Who is affected: State Medicaid programs, especially expansion states; noncitizens who are not “qualified” under federal law; lawfully residing children and pregnant women are not included in these restrictions.
• What changes: The noncitizen eligibility change starts sooner (now July 4, 2025). Federal Medicaid expansion funding rules are tied to whether a state uses its own funds to cover certain noncitizens, with “specified State” status and funding calculations made each quarter .
• When: The eligibility date change takes effect as if it had been part of the earlier law, with the new date set to July 4, 2025.