Excluding Illegal Aliens from Medicaid Act
Sponsored By: Senator Rand Paul
Introduced
Summary
Accelerates exclusion of certain non‑qualified immigrants from Medicaid and increases federal matching for states that pay for their care. This bill moves the effective date for new rules on alien Medicaid eligibility up to July 4, 2025 and changes how the Federal Medical Assistance Percentage is calculated for states that fund coverage for these individuals.
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- States: For calendar quarters beginning on or after July 4, 2025, a State that provides general‑fund assistance to non‑qualified aliens or gives them comprehensive health benefits can be treated as a "specified State" and have its FMAP (Federal Medical Assistance Percentage) determined under subsection (b), which raises the FMAP for those quarters.
- Non‑qualified immigrants and families: The timing of changes to Medicaid eligibility that affect aliens who are not "qualified aliens" and who are not lawfully residing children or pregnant women is moved earlier to July 4, 2025, so eligibility rules apply sooner.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 0 benefits, 2 costs, 1 mixed.
Medicaid access for non‑qualified immigrants
This bill would move up a Medicaid eligibility change for non‑qualified immigrants. It replaces the October 1, 2026 date with July 4, 2025, and counts the change as if it were in the original law. If enacted, households with non‑qualified immigrants could lose Medicaid eligibility starting July 4, 2025.
Lower federal Medicaid match for States
This bill would define when a State is a "specified State" if it uses state general funds to help non‑qualified immigrants buy coverage or gives them comprehensive coverage. For calendar quarters starting July 4, 2025, a specified State's federal Medicaid match would be determined under a different formula. If enacted, this can lower federal payments for those States and affect Medicaid resources where you live.
Medicaid match reporting moves to quarters
This bill would change some Medicaid timing language from annual to quarterly periods. That means certain calculations and reports would use calendar quarters instead of years. If enacted, States and program offices would use quarters for the named reporting periods when the bill takes effect.
Sponsors & CoSponsors
Sponsor
Rand Paul
KY • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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