H.R. 4209

119th CONGRESS 1st Session

To amend titles XIX and XXI of the Social Security Act to prohibit Federal financial participation under Medicaid and CHIP for individuals without verified citizenship, nationality, or satisfactory immigration status.

IN THE HOUSE OF REPRESENTATIVES · June 26, 2025 · Sponsor: Mr. Van Drew · Committee: Committee on Energy and Commerce

Table of contents

• H.R. 4209
  • SEC. 1. Short title
  • SEC. 2. Prohibiting Federal financial participation under Medicaid and CHIP for individuals without verified citizenship, nationality, or satisfactory immigration status

SEC. 1. Short title

• This Act may be cited as the No Medicaid for Illegals Act.

SEC. 2. Prohibiting Federal financial participation under Medicaid and CHIP for individuals without verified citizenship, nationality, or satisfactory immigration status

• (a) In general
  • (1) Medicaid
    • Section 1903(i)(22) of the Social Security Act () is amended— 42 U.S.C. 1396b(i)(22)
      • by adding at the end; and
      • by striking and inserting
        • to—
          • amounts
          • in the case that the State elects under section 1902(a)(46)(C) to provide for making medical assistance available to an individual during—
            • (i) the period in which the individual is provided the reasonable opportunity to present satisfactory documentary evidence of citizenship or nationality under section 1902(ee)(2)(C) or subsection (x)(4);
            • (ii) the 90-day period described in section 1902(ee)(1)(B)(ii)(II); or
            • (iii) the period in which the individual is provided the reasonable opportunity to submit evidence indicating a satisfactory immigration status under section 1137(d)(4),
          • amounts expended for such medical assistance, unless the citizenship or nationality of such individual or the satisfactory immigration status of such individual (as applicable) is verified by the end of such period;
      • by adding at the end the following new subparagraph:
  • (2) CHIP
    • Section 2107(e)(1)(N) of the Social Security Act () is amended by striking and (17)and inserting (17), and (22). 42 U.S.C. 1397gg(e)(1)(N)
• (b) Eliminating State requirement To provide medical assistance during reasonable opportunity period
  • (1) Documentary evidence of citizenship or nationality
    • Section 1903(x)(4) of the Social Security Act () is amended— 42 U.S.C. 1396b(x)
      • by striking under clauses (i) and (ii) of section 1137(d)(4)(A)and inserting under section 1137(d)(4); and
      • by inserting before the period at the end.
  • (2) Social Security data match
    • Section 1902(ee) of the Social Security Act () is amended— 42 U.S.C. 1396a(ee)
      • in paragraph (1)(B)(ii)—
        • (i) in subclause (II), by striking (and continues to provide the individual with medical assistance during such 90-day period)and inserting and, if the State has elected the option under subsection (a)(46)(C), continues to provide the individual with medical assistance during such 90-day period; and
        • (ii) in subclause (III), by inserting after ; and
      • in paragraph (2)(C)—
        • (i) by striking under clauses (i) and (ii) of section 1137(d)(4)(A)and inserting under section 1137(d)(4); and
        • (ii) by inserting before the period at the end.
  • (3) Individuals with satisfactory immigration status
    • Section 1137(d)(4) of the Social Security Act () is amended— 42 U.S.C. 1320b–7(d)(4)
      • in subparagraph (A)(ii), by inserting after ; and
      • in subparagraph (B)(ii), by inserting after .
• (c) Option To continue providing medical assistance during reasonable opportunity period
  • (1) Medicaid
    • Section 1902(a)(46) of the Social Security Act () is amended— 42 U.S.C. 1396a(a)(46)
      • in subparagraph (A), by striking and at the end;
      • in subparagraph (B)(ii), by adding at the end; and
        • provide, at the option of the State, for making medical assistance available—
          • (i) to an individual described in subparagraph (B) during the period in which such individual is provided the reasonable opportunity to present satisfactory documentary evidence of citizenship or nationality under subsection (ee)(2)(C) or section 1903(x)(4), or during the 90-day period described in subsection (ee)(1)(B)(ii)(II); or
          • (ii) to an individual who is not a citizen or national of the United States during the period in which such individual is provided the reasonable opportunity to submit evidence indicating a satisfactory immigration status under section 1137(d)(4);
      • by inserting after subparagraph (B)(ii) the following new subparagraph:
  • (2) CHIP
    • Section 2105(c)(9) of the Social Security Act () is amended by adding at the end the following new subparagraph: 42 U.S.C. 1397ee(c)(9)
      • (C) Option to continue providing child health assistance during reasonable opportunity period
        • Section 1902(a)(46)(C) shall apply to States under this title in the same manner as it applies to a State under title XIX.
• (d) Effective date
  • The amendments made by this section shall apply beginning on the date of the enactment of this Act.