Health Equity and Access under the Law for Immigrant Families Act of 2025
Sponsored By: Senator Cory Booker
Introduced
Summary
This bill would expand federal health coverage access for immigrants by removing immigration-based barriers that limit eligibility for Medicaid, CHIP, ACA marketplace subsidies, and Medicare.
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- Families could see children and pregnant women gain eligibility for Medicaid and CHIP, and states could opt to cover people without lawful presence under new targeted eligibility categories. The bill also bars sponsors from being billed under an affidavit of support for medical assistance provided to lawfully residing individuals.
- People with Federally authorized presence would be treated as lawfully present for ACA exchange eligibility, premium tax credits, and reduced cost sharing. The bill would also authorize some without lawful presence to buy coverage on ACA exchanges and makes key subsidy and eligibility changes effective for years and plan years beginning after December 31, 2025.
- Medicare Parts A and B definitions would change to include individuals who are lawfully present, including those with deferred action or other Federally authorized presence. That definition is tied to the categories the bill adds for Medicaid and CHIP eligibility.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
More Medicaid and CHIP access for immigrants
If enacted, States would be allowed to give Medicaid to people who lawfully live in the U.S. if they meet other State rules. The bill would let States add a CHIP option to cover children or pregnant women without lawful presence. Services would be covered starting 90 days after enactment, though States must formally adopt the options in their plans before they apply.
Treat federally authorized presence as lawful
If enacted, people granted Federally authorized presence would be treated as "lawfully present" for Marketplace enrollment, premium help, reduced cost-sharing, and Medicaid/CHIP eligibility. That rule would take effect on enactment. The Health Department would be required to open a special enrollment period for people who get that status before the first open enrollment; for people who already have it at enactment, that period must start within 90 days.
Premium tax credits for noncitizens preserved
If enacted, some noncitizen taxpayers who were barred from premium tax credits only because of immigration-based Medicaid ineligibility would be able to claim credits for tax years after December 31, 2025. The bill would also preserve prior premium tax credit and Medicaid-related subsidy access for lawfully present noncitizens who qualified under pre-enactment rules. It defines "full benefits" so officials can tell who keeps prior subsidy rules.
Medicare eligibility for lawfully present
If enacted, Medicare language would explicitly include people who are lawfully present, including those with approved or pending deferred action. That change would clarify who can qualify for Medicare Part A and Part B and could let some noncitizen seniors enroll.
Marketplace eligibility and payment changes
If enacted, several Marketplace rules would change for years after December 31, 2025. The bill would remove a residency limit that kept some noncitizens out of Marketplace enrollment. It would also repeal certain cost-sharing reductions and change rules about federal payments and Basic Health Program eligibility. These edits could let more people enroll but also change how much enrollees and plans pay.
Sponsors & CoSponsors
Sponsor
Cory Booker
NJ • D
Cosponsors
Martin Heinrich
NM • D
Sponsored 6/24/2025
Alex Padilla
CA • D
Sponsored 6/24/2025
Elizabeth Warren
MA • D
Sponsored 6/24/2025
Patty Murray
WA • D
Sponsored 6/24/2025
Mazie Hirono
HI • D
Sponsored 6/24/2025
Bernie Sanders
VT • I
Sponsored 6/24/2025
Richard Blumenthal
CT • D
Sponsored 6/24/2025
Edward Markey
MA • D
Sponsored 6/24/2025
Timothy Kaine
VA • D
Sponsored 7/9/2025
Roll Call Votes
No roll call votes available for this bill.
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