HR4104119th CongressWALLET

Health Equity and Access under the Law for Immigrant Families Act of 2025

Sponsored By: Representative Jayapal

Introduced

Summary

Expands federal health coverage and Marketplace subsidies for immigrants by removing status-based barriers across Medicaid, CHIP, the ACA exchanges, and Medicare. The bill would align immigration categories used by health programs so many lawfully present people can access the same benefits and subsidies as citizens.

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 5 benefits, 0 costs, 0 mixed.

Authorized presence counts for coverage

People with Federally authorized presence would count as lawfully present for the Marketplace, subsidies, Medicaid, and CHIP. This would take effect on enactment. They would get a special enrollment window, starting within 90 days if they already have that status. Lawfully present noncitizens who cannot get full Medicaid would keep any premium tax credits and their pre‑enactment Medicaid access rules.

Marketplace subsidies for more immigrants

Starting in 2026, some noncitizens who cannot get Medicaid because of status could get Marketplace premium tax credits. The bill would change cost‑sharing and Basic Health Program rules to include more noncitizens. It would remove ACA language that limits Exchange access to citizens and lawful residents and adjust payment and minimum‑coverage text. These changes would apply for years, plan years, and taxable years beginning after December 31, 2025.

Medicaid for lawfully residing immigrants

The bill would require states to give Medicaid to lawfully residing people who meet other rules, including certain battered individuals and those with approved or pending deferred action. Coverage would apply to care given starting 90 days after enactment. It would define full Medicaid benefits and align CHIP rules to match these immigrant categories. Sponsors would not owe debt for this care. States that need new laws would get time until after their next regular session.

Medicare access for lawfully present

Lawfully present people, including those with approved or pending deferred action, would be able to enroll in Medicare Parts A and B. Medicare would use the same lawfully present categories as Medicaid. This would take effect upon enactment.

States could cover undocumented residents

States could choose to cover residents without lawful status under Medicaid and CHIP if they would qualify as citizens. This would take effect on enactment and would require a state plan or waiver election. Federal limits would not block these state choices. Medicaid payments would be allowed for the new eligibility group.

Sponsors & CoSponsors

Sponsor

Jayapal

WA • D

Cosponsors

  • Barragan

    CA • D

    Sponsored 6/24/2025

  • Balint

    VT • D

    Sponsored 6/24/2025

  • Beyer

    VA • D

    Sponsored 6/24/2025

  • Bonamici

    OR • D

    Sponsored 6/24/2025

  • Carbajal

    CA • D

    Sponsored 6/24/2025

  • Carson

    IN • D

    Sponsored 6/24/2025

  • Carter (LA)

    LA • D

    Sponsored 6/24/2025

  • Casar

    TX • D

    Sponsored 6/24/2025

  • Castor (FL)

    FL • D

    Sponsored 6/24/2025

  • Castro (TX)

    TX • D

    Sponsored 6/24/2025

  • Cherfilus-McCormick

    FL • D

    Sponsored 6/24/2025

  • Chu

    CA • D

    Sponsored 6/24/2025

  • Crockett

    TX • D

    Sponsored 6/24/2025

  • DelBene

    WA • D

    Sponsored 6/24/2025

  • Dexter

    OR • D

    Sponsored 6/24/2025

  • Doggett

    TX • D

    Sponsored 6/24/2025

  • Espaillat

    NY • D

    Sponsored 6/24/2025

  • Frost

    FL • D

    Sponsored 6/24/2025

  • Garcia (IL)

    IL • D

    Sponsored 6/24/2025

  • Garcia (CA)

    CA • D

    Sponsored 6/24/2025

  • Garcia (TX)

    TX • D

    Sponsored 6/24/2025

  • Gomez

    CA • D

    Sponsored 6/24/2025

  • Huffman

    CA • D

    Sponsored 6/24/2025

  • Jackson (IL)

    IL • D

    Sponsored 6/24/2025

  • Jacobs

    CA • D

    Sponsored 6/24/2025

  • Johnson (GA)

    GA • D

    Sponsored 6/24/2025

  • Khanna

    CA • D

    Sponsored 6/24/2025

  • Krishnamoorthi

    IL • D

    Sponsored 6/24/2025

  • Leger Fernandez

    NM • D

    Sponsored 6/24/2025

  • McClellan

    VA • D

    Sponsored 6/24/2025

  • McGovern

    MA • D

    Sponsored 6/24/2025

  • Moore (WI)

    WI • D

    Sponsored 6/24/2025

  • Nadler

    NY • D

    Sponsored 6/24/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 6/24/2025

  • Omar

    MN • D

    Sponsored 6/24/2025

  • Panetta

    CA • D

    Sponsored 6/24/2025

  • Pocan

    WI • D

    Sponsored 6/24/2025

  • Pressley

    MA • D

    Sponsored 6/24/2025

  • Ramirez

    IL • D

    Sponsored 6/24/2025

  • Salinas

    OR • D

    Sponsored 6/24/2025

  • Schakowsky

    IL • D

    Sponsored 6/24/2025

  • Sewell

    AL • D

    Sponsored 6/24/2025

  • Simon

    CA • D

    Sponsored 6/24/2025

  • Stansbury

    NM • D

    Sponsored 6/24/2025

  • Strickland

    WA • D

    Sponsored 6/24/2025

  • Thanedar

    MI • D

    Sponsored 6/24/2025

  • Tlaib

    MI • D

    Sponsored 6/24/2025

  • Vargas

    CA • D

    Sponsored 6/24/2025

  • Velazquez

    NY • D

    Sponsored 6/24/2025

  • Wasserman Schultz

    FL • D

    Sponsored 6/24/2025

  • Watson Coleman

    NJ • D

    Sponsored 6/24/2025

  • Williams (GA)

    GA • D

    Sponsored 6/24/2025

  • Wilson (FL)

    FL • D

    Sponsored 6/24/2025

  • Lieu

    CA • D

    Sponsored 6/24/2025

  • Sanchez

    CA • D

    Sponsored 6/24/2025

  • Clarke (NY)

    NY • D

    Sponsored 6/25/2025

  • Adams

    NC • D

    Sponsored 6/26/2025

  • Correa

    CA • D

    Sponsored 7/2/2025

  • Quigley

    IL • D

    Sponsored 7/2/2025

  • Randall

    WA • D

    Sponsored 7/10/2025

  • Tokuda

    HI • D

    Sponsored 7/14/2025

  • Rivas

    CA • D

    Sponsored 7/14/2025

  • Escobar

    TX • D

    Sponsored 7/14/2025

  • Evans (PA)

    PA • D

    Sponsored 7/16/2025

  • Kamlager-Dove

    CA • D

    Sponsored 7/16/2025

  • Amo

    RI • D

    Sponsored 7/16/2025

  • Menendez

    NJ • D

    Sponsored 7/21/2025

  • Green, Al (TX)

    TX • D

    Sponsored 7/22/2025

  • Scanlon

    PA • D

    Sponsored 7/23/2025

  • Pingree

    ME • D

    Sponsored 7/23/2025

  • Veasey

    TX • D

    Sponsored 8/1/2025

  • DeSaulnier

    CA • D

    Sponsored 8/29/2025

Roll Call Votes

No roll call votes available for this bill.

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