Sponsors (15)
The bill secures taxpayer-funded subsidy dollars for U.S. citizens and creates uniform federal application by rescinding conflicting waivers, but does so by sharply reducing state waiver flexibility and risking abrupt disruptions to state programs and coverage—particularly for lawfully present immigrants and uninsured populations.
U.S. taxpayers and U.S. citizens retain exclusive access to State §1332 pass‑through funds for premium/subsidy assistance, ensuring taxpayer‑funded subsidies are reserved for citizens and nationals.
State waivers that conflict with the new statutory rule would be rescinded, creating uniformity and immediate alignment across States and clarifying program administration for HHS and state governments.
States and uninsured individuals could face abrupt disruptions if previously approved waivers are rescinded within 30 days, potentially pulling funding or program elements and interrupting coverage or planned programs.
Lawfully present immigrants and some state populations may lose coverage options because States lose flexibility to design waivers that count certain legal‑resident populations when calculating subsidies.
Excluding section 1312(f)(3) from eligible waiver provisions narrows States' ability to waive certain ACA requirements, limiting experimentation or innovations to lower costs or expand coverage.
Based on analysis of 2 sections of legislative text.
Prohibits states from using ACA §1332 federal pass-through funds to pay for coverage or subsidies for people who are not U.S. citizens/nationals or not lawfully present and requires rescission of conflicting waivers.
Introduced March 5, 2026 by Lauren Boebert · Last progress March 5, 2026
Amends the Affordable Care Act's state innovation waiver rules to prohibit states from using federal pass-through funds to buy coverage, premium subsidies, cost-sharing reductions, or other benefits for people who are not U.S. citizens, U.S. nationals, or aliens lawfully present. It also narrows the list of ACA requirements that a state may waive and directs the HHS Secretary to rescind, within 30 days, any previously approved waivers that would not have been allowed under the new rule. One provision only sets a short title and has no operational effect; the substantive change is limited to restricting how states may use federal §1332 pass-through funds and requiring rescission of conflicting prior waivers.