Requires 12-month continuous enrollment for people in Medicaid and the Children’s Health Insurance Program (CHIP), so eligible enrollees keep coverage for a full year regardless of interim changes in circumstances. The amendment modifies the Medicaid and CHIP statutory language and takes effect on the first day of the first fiscal quarter that begins on or after December 31, 2026.
In Section 1902(e)(12) of the Social Security Act (42 U.S.C. 1396a(e)(12)), as amended by section 5112 of the Consolidated Appropriations Act, 2023, the header is amended by striking ;
In Section 1902(e)(12), the matter preceding subparagraph (A) is amended by striking ;
In Section 1902(e)(12), in subparagraph (A) an addition is made at the end adding: "or"
In Section 1902(e)(12), subparagraph (B) is struck.
In Section 1902(e)(12), subparagraph (C) is redesignated as subparagraph (B).
Directly affected: current and prospective Medicaid and CHIP enrollees, especially low-income children, pregnant people, parents, and adults who rely on these programs. Beneficiaries will generally experience more stable coverage for a full year after enrollment, reducing interruptions in care and prescription access. States administer Medicaid and CHIP and must revise eligibility, renewal, and information systems; this creates administrative workload and potential short-term costs for systems changes, but may reduce administrative churn over time. Health care providers and managed care plans may see fewer uninsured visits and more predictable patient coverage. Federal and state budgets will be affected by changes in months of coverage per enrollee and utilization; continuous enrollment typically increases average enrollment duration (raising program outlays) but can lower administrative costs from fewer redeterminations. Implementation details (CMS guidance, permissible exceptions, and transitional rules) will shape the ultimate operational and fiscal impacts.
Read twice and referred to the Committee on Finance.
Last progress June 12, 2025 (8 months ago)
Introduced on June 12, 2025 by Sheldon Whitehouse
Updated 1 week ago
Last progress June 17, 2025 (7 months ago)
