Sponsors (6)
The bill expands Medicaid coverage for newborns, young adults, and immigrants and reduces state costs via full federal reimbursement, but it raises federal spending, creates state administrative burdens and short-term enrollment hassles, and introduces tax-eligibility complexities.
Young people — children born in-state and individuals under age 26 — will gain immediate or categorical Medicaid coverage (automatic enrollment at birth and new eligibility for under-26s), increasing access to health care for families and low-income young adults.
People present in the U.S. regardless of immigration status will be eligible under the new Medicaid category, expanding health coverage to immigrants who are currently excluded.
States will receive 100% Federal Medical Assistance Percentage (FMAP) for expenditures for the newly eligible group, lowering state budget pressure for covering these individuals.
Federal taxpayers will likely face higher federal Medicaid spending because expanded eligibility and 100% FMAP increase federal outlays for the newly eligible population.
State Medicaid agencies must build and run automatic enrollment and opt-out systems, creating administrative, IT, and implementation costs and operational burdens for states.
Automatic enrollment may enroll people who already have other coverage, forcing families and insured individuals to opt out and handle paperwork, creating duplicate-coverage risk and short-term administrative hassle.
Based on analysis of 2 sections of legislative text.
Expands Medicaid to under-26s, mandates newborn automatic enrollment with opt-out, and requires eligibility regardless of immigration status (most changes start 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 and requires automatic enrollment for newborns and many young people. The bill adds eligibility for individuals under age 26, creates automatic enrollment at birth with a parent/guardian notice and opt-out process when other adequate coverage exists, and—beginning two years after enactment—requires States to provide certain Medicaid eligibility regardless of immigration status. The measure also changes related statutory language on continuous eligibility, adjusts how eligibility-only Medicaid is treated for premium tax credit (minimum essential coverage) purposes, and makes related technical changes to notices and opt-out procedures for those aging out of child coverage.