Sponsors (16)
The bill secures taxpayer-funded subsidies exclusively for U.S. citizens and creates uniform federal rules by rescinding conflicting state waivers, but does so at the cost of state flexibility and with a rapid rescission timeline that could disrupt coverage and programs—particularly affecting lawfully present immigrants and vulnerable populations.
All U.S. citizens and nationals retain exclusive access to State Section 1332 pass-through funds for coverage subsidies, preventing those taxpayer-funded subsidies from being used to subsidize noncitizens.
Previously approved waivers that conflict with the new statutory rule are rescinded, creating immediate uniformity and simpler administration across states and aligning state programs with the Secretary of HHS.
Rescinding previously approved waivers within 30 days could abruptly terminate or withdraw funding and program elements, disrupting coverage and planned state programs for people currently enrolled or relying on them.
States lose flexibility to design waiver programs that count certain lawfully present immigrants in subsidy calculations and cannot use Section 1312(f)(3)-style waiver authority, reducing options to expand coverage or pursue innovative cost-lowering approaches and potentially leaving some immigrants uninsured.
Based on analysis of 2 sections of legislative text.
Prohibits states from using ACA §1332 pass‑through funds to pay for coverage or financial assistance for noncitizens not lawfully present, narrows waiver scope, and requires rescission of inconsistent waivers.
Official title: To amend the Patient Protection and Affordable Care Act to ensure that taxpayer funds for health insurance coverage are available only to authorized individuals, and for other purposes.
Introduced March 5, 2026 by Lauren Boebert · Last progress March 5, 2026
Amends the Affordable Care Act’s State Innovation Waiver (42 U.S.C. §18052 / §1332) to stop states from using federal “pass‑through” savings to provide insurance coverage, premiums, cost‑sharing reductions, or other benefits to people who are not U.S. citizens, nationals, or lawfully present aliens. It also narrows the list of ACA requirements that a state may waive and requires the HHS Secretary to rescind any previously approved §1332 waivers within 30 days if those waivers would not have been approved under the new rules. The measure takes effect on enactment and applies prospectively and retroactively to prior §1332 approvals (by requiring rescission of inconsistent waivers), limiting state flexibility to use federal pass‑through funds to cover certain noncitizen populations under state waiver programs.