Sponsors (5)
The bill expands Medicaid coverage for young adults, newborns, and immigrants and eases state costs for coverage, but does so at the expense of higher federal spending and new administrative, legal, and tax-administration burdens that states, families, and taxpayers will need to manage.
Young adults (those under 26) who are low-income will gain categorical Medicaid eligibility beginning two years after enactment, increasing their access to health coverage and care.
Children born in-state on or after two years after enactment will be automatically enrolled in Medicaid at birth (unless parents opt out), ensuring immediate newborn access to health services.
States will receive 100% Federal Medical Assistance Percentage (FMAP) for expenditures for the newly eligible individuals under the new category, lowering state costs for covering these populations.
Taxpayers nationwide may face higher federal Medicaid spending because the expansion and 100% FMAP for newly eligible individuals will increase federal outlays.
State Medicaid agencies will incur administrative and IT implementation costs to build automatic enrollment and opt-out systems, placing short- to medium-term burdens on state budgets and operations.
Changes to the definition of 'minimum essential coverage' that exclude eligibility-only status unless actually enrolled could complicate premium tax credit eligibility and force individuals to ensure active enrollment to avoid tax consequences.
Based on analysis of 2 sections of legislative text.
Expands Medicaid to under-26s on enactment, requires automatic newborn enrollment and opt-outs, and extends eligibility regardless of immigration status beginning two years after enactment.
Official title: Amend title XIX of the Social Security Act to make all children eligible for Medicaid from birth until age 26, to require States to automatically enroll children and young adults under age 26 in the State Medicaid program, and for other purposes.
Introduced July 21, 2026 by Andy Kim · Last progress July 21, 2026
Extends Medicaid eligibility to people under age 26 immediately and requires automatic enrollment of newborns and continuity rules, with major operative changes taking effect two years after enactment. Beginning two years after enactment, States must also provide eligibility-based Medicaid to any individual residing or present in the U.S. regardless of immigration status and must implement automatic-enrollment notices and opt-outs for children who turn 18. The bill also adjusts related tax rules so eligibility-only Medicaid that an individual is not actually enrolled in does not count as minimum essential coverage for premium tax credit calculations, and it changes continuity-of-eligibility and enrollment-notice rules across Medicaid program statutes. Some provisions take effect on enactment while others are delayed two years to allow implementation.