Health Equity and Access under the Law for Immigrant Families Act of 2025
Health Equity and Access under the Law for Immigrant Families Act of 2025 is a comprehensive effort to broaden health coverage for immigrants and their families by removing legal and policy barriers across multiple programs. The bill aims to extend eligibility for federally funded health care programs to more people who are lawfully present, to allow undocumented individuals to access health insurance through ACA marketplaces, and to give states options to expand Medicaid and CHIP to people without lawful presence. It also removes several citizenship- and status-based limits on ACA subsidies, enhances access to Medicare for those with Federally authorized presence, and creates transitional enrollment provisions to smooth the transition for newly eligible populations. Overall, the bill seeks to reduce barriers to coverage for immigrant communities and to promote broader health coverage and equity. Key elements include expanding Medicaid/CHIP eligibility to more lawfully present individuals (and certain others with pending or approved presence), providing special enrollment opportunities, allowing states to extend Medicaid/CHIP to people without lawful presence, removing certain ACA eligibility restrictions tied to immigration status, and updating Medicare to recognize lawfully present individuals. The bill envisions both immediate effects (through enactment and shortly after) and longer-term state choices that could broaden coverage for immigrants and undocumented individuals.
Key Points
- 1Expands Medicaid and CHIP eligibility for lawfully residing individuals (including those with approved or pending deferred action or other Federally authorized presence) and eliminates certain sponsor debt liabilities, extending coverage to more immigrant families.
- 2Enables undocumented individuals to access health insurance through the ACA exchanges by creating a pathway for subsidies and subsidies-related eligibility, including a special enrollment period for those granted Federally authorized presence.
- 3Removes or relaxes several ACA-related barriers tied to immigration status, including premium tax credits, cost-sharing reductions, and minimum coverage requirements, while expanding the reach of subsidies to a broader group of immigrants.
- 4Permits states to expand Medicaid and CHIP to individuals without lawful presence by adding new eligibility categories and a state option (including a new CHIP provision for targeted low-income individuals without lawful presence).
- 5Updates Medicare eligibility by replacing certain references to “alien” with “lawfully present,” thereby broadening Part A and Part B eligibility to include individuals with Federally authorized presence or pending/approved presence. The definition of “lawfully present” is aligned with the Act’s earlier Section 3 changes.
- 6Establishes transitional and effective-date rules, including immediate effect for many provisions, 90-day post-enactment applicability for some Medicaid/CHIP changes, and a special enrollment period process for newly eligible individuals under the ACA.