Sponsors (76)
The bill would materially expand eligibility and financial help so many lawfully present noncitizens gain affordable coverage—improving access and reducing uncompensated care—but it substantially increases federal/state costs, administrative burden, and political/legal risks that could affect budgets and rollout.
Lawfully present immigrants (including many LPRs and those with federally authorized presence) would gain eligibility to enroll in Medicaid, CHIP, Medicare-linked benefits, and the ACA Marketplace, materially increasing access to preventive and primary care.
Low- and moderate-income noncitizens would become eligible for premium tax credits and cost‑sharing reductions, lowering premiums and out‑of‑pocket costs and improving affordability.
Children and families (including children without lawful presence in some cases) would see expanded or clarified access to CHIP, Basic Health Program, and reduced cost sharing, improving pediatric preventive and family coverage.
Taxpayers and federal/state budgets would face increased costs because expanding eligibility, subsidies, and clarified Medicare/Medicaid coverage raises federal and likely state spending.
States could confront significant budgetary pressure and reduced flexibility—higher enrollment and lost targeting tools may force states to reallocate funds, raise revenue, or cut other programs.
Implementation will add administrative complexity and short‑term burdens for states, exchanges, HHS, and Treasury (system updates, verifications, SEP processing), creating enrollment churn, delays, and potential errors during roll‑out.
Based on analysis of 8 sections of legislative text.
Treats federally authorized and other lawfully present noncitizens as eligible for Medicaid, CHIP, Exchanges, premium tax credits, and cost‑sharing reductions; lets States opt to cover undocumented people.
Official title: To expand access to health insurance coverage for immigrants and their families by removing legal and policy barriers to health insurance coverage, and for other purposes.
Introduced June 24, 2025 by Pramila Jayapal · Last progress June 24, 2025
Makes most noncitizen residents of the United States eligible for federal health programs and tax credits by treating people with federally authorized presence and other lawfully present categories as "lawfully present" for Medicaid, CHIP, Medicare, Exchange enrollment, premium tax credits, and cost‑sharing reductions. It requires States to provide Medicaid and CHIP to lawfully present individuals who meet other eligibility rules, removes certain immigration‑based exclusions in the Affordable Care Act and Internal Revenue Code, and gives States the option to extend Medicaid/CHIP to people without lawful presence.