Sponsors (10)
The bill substantially expands health coverage access for lawfully present (and, in opt-in states, some nonlawfully present) immigrants—improving care and reducing uncompensated costs—while increasing federal/state spending, administrative burdens, verification challenges, and political controversy.
Lawfully present immigrants (including LPRs) will gain eligibility for Medicaid, CHIP, Marketplace coverage, premium tax credits, and Medicare protections, expanding access to health care for millions.
Children and pregnant people in immigrant families will see more consistent coverage under CHIP/Medicaid, reducing uninsured rates and improving preventive and maternal care.
Noncitizen adults and children without lawful presence in states that opt in can obtain Medicaid/CHIP coverage (and undocumented people could access Exchanges), reducing uninsured rates where states choose to expand.
Taxpayers will likely face higher federal (and in some cases state) spending to subsidize expanded Marketplace credits and to cover additional Medicaid/Medicare enrollees.
States may lose flexibility or face new budget pressures from higher Medicaid/CHIP enrollment, forcing trade-offs in state spending or program design.
Implementing expanded eligibility will create administrative complexity — updating IT systems, certifying benefits, verifying immigration status, and changing enrollment processes — increasing workloads and transitional costs for agencies and exchanges.
Based on analysis of 8 sections of legislative text.
Expands Medicaid, CHIP, ACA marketplace eligibility and subsidies to many noncitizens (including those with Federally authorized presence) and allows states to cover non-lawfully-present individuals.
Introduced June 24, 2025 by Cory Anthony Booker · Last progress June 24, 2025
Makes most immigrants in the United States eligible for federally supported health coverage. Lawfully present noncitizens would become eligible for Medicaid, CHIP, and ACA marketplace coverage and subsidies; people granted “Federally authorized presence” would be treated as lawfully present for enrollment and subsidies; and states would be allowed to opt to cover noncitizens without lawful presence. The bill also removes immigration-based restrictions in the tax code and ACA that block premium tax credits and cost‑sharing reductions for some noncitizens and aligns Medicare text to the expanded definition of “lawfully present.” Implementation is phased: some rules take effect on enactment (or within 90 days), while ACA and tax-year changes apply to plan/tax/calendar years beginning after December 31, 2025. The measure preserves certain existing protections for noncitizens who previously lacked full Medicaid benefits.