HR 2445119th CongressIn Committee

Ensuring Medicaid Eligibility Act of 2025

Introduced: Mar 27, 2025

Standard Summary

Comprehensive overview in 1-2 paragraphs

The Ensuring Medicaid Eligibility Act of 2025 would block the implementation of a 2024 DHS/HHS rule that aimed to streamline Medicaid, CHIP, and Basic Health Program application, eligibility determination, enrollment, and renewal processes. It also tightens eligibility rules by requiring states to verify citizenship or immigration status before enrolling individuals and mandating that income-based eligibility be verified at least quarterly. Additionally, the bill would bar federal Medicaid payments for certain noncitizen groups—parolees, individuals with Deferred Action or Deferred Enforced Departure, as well as asylum seekers, Temporary Protected Status recipients, and those with withholding of removal—effectively limiting Medicaid coverage for these populations. The act would modify several sections of the Social Security Act to implement these changes, and it carries the overall aim of restricting or restructuring how Medicaid eligibility and enrollment are handled, particularly for immigrant populations.

Key Points

1Prohibits implementation, enforcement, or any effect of the April 2, 2024 rule titled “Medicaid Program; Streamlining the Medicaid, Children's Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes.”
2Adds enrollment prerequisites and ongoing verification:
3- No enrollment in Medicaid (or a waiver) until a state verifies citizenship or national status or satisfactory immigration status (as defined in the INA).
4- For individuals whose eligibility partly depends on income, requires verification of that income not less frequently than quarterly.
5Limits Medicaid payments for certain noncitizen groups:
6- Prohibits federal Medicaid payments for medical assistance to aliens granted parole, deferred action/DE, asylum, TPS, or withholding of removal.
7- Amends the relevant section of the Social Security Act to reference these aliens in the Medicaid ineligibility/payments context.
8Conforming amendment to 1902(a) to reflect eligibility/verification changes for aliens described in the new provision.
9Short title: “Ensuring Medicaid Eligibility Act of 2025.”

Impact Areas

Primary group/area affected- Immigrant populations and individuals with certain immigration statuses (parole, DACA, asylum, TPS, withholding) who would face limitations on Medicaid eligibility or federal funding for Medicaid.- State Medicaid programs, which would bear administrative consequences from new verification requirements and potential changes in which individuals are eligible for coverage.Secondary group/area affected- Health care providers and clinics that serve Medicaid patients, due to potential changes in enrollment timelines and payer eligibility.- Federal budgeting and subsidy programs, given the proposed restrictions on federal Medicaid payments to certain noncitizen groups.Additional impacts- Administrative burden on states to perform citizenship/immigration status verification prior to enrollment and to conduct more frequent (quarterly) income verifications.- Potential changes in Medicaid enrollment numbers and the timing of enrollments, with possible gaps or delays for affected populations.- Legal and administrative considerations related to immigration status verification and data sharing between agencies.

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