HR 584119th CongressIn Committee

No Medicaid for Illegal Immigrants Act of 2025

Introduced: Jan 21, 2025

Standard Summary

Comprehensive overview in 1-2 paragraphs

H.R. 584, titled the No Medicaid for Illegal Immigrants Act of 2025, would amend the Social Security Act to bar Medicaid medical assistance under state Medicaid plans (including waivers) for aliens who are not lawfully admitted for permanent residence or not permanently residing in the United States under color of law. The new prohibition is added as a new paragraph (88) to section 1902(a) and would apply “notwithstanding” certain other provisions (specifically 1903(v)(4)). There is an explicit exception for any medical assistance payments that are permitted under section 1903(v)(2). In short, the bill would narrow eligibility for Medicaid to ensure that most non-permanent-resident aliens do not receive covered benefits under state Medicaid programs, while preserving a narrow carve-out tied to the existing 1903(v)(2) authority. The bill was introduced in the House by a sponsor from California (Mr. Kiley) on January 21, 2025, and referred to the Committee on Energy and Commerce. It does not provide a Senate companion text within the excerpt, and there is no enacted law at this time.

Key Points

1Core change: The bill prohibits providing any medical assistance under a state Medicaid plan or its waiver to aliens who are not lawfully admitted for permanent residence or not permanently residing in the United States under color of law.
2Explicit exception: The prohibition does not apply to medical assistance paid under section 1903(v)(2) of the Social Security Act (i.e., certain types of assistance described in that provision).
3Supersession of other rules: The new prohibition is stated to operate notwithstanding section 1903(v)(4), meaning it overrides that provision for the affected individuals.
4Scope of “medical assistance”: The prohibition covers benefits under a state plan or waiver, but the text indicates some narrowly defined benefits may still be available if they fall under the 1903(v)(2) category.
5Status and sponsor: Introduced in the House by Rep. Kiley (CA) on January 21, 2025; referred to the Committee on Energy and Commerce. This is a proposal and not yet law.

Impact Areas

Primary group/area affected:- Non-permanent-resident aliens (e.g., undocumented immigrants and certain non-permanent residents) would be ineligible for Medicaid benefits under state plans, subject to the 1903(v)(2) exception.Secondary group/area affected:- State Medicaid programs and their budgets, since coverage for a broad group of non-citizens could be reduced or eliminated, potentially shifting costs to individuals, providers, or other programs.- Health care providers and hospitals that previously served those populations and relied on Medicaid reimbursement.Additional impacts:- Access to care: Potential reduction in coverage for affected individuals could affect access to routine and preventive services, with possible increases in uncompensated care or delayed care.- Administrative effects: States would need to modify eligibility systems, enrollment rules, and plan documents to reflect the new eligibility restrictions.- Legal and policy considerations: The bill raises questions about federal-state funding reach, immigration-related policy, and potential litigation or challenges based on current law, state autonomy, or constitutional grounds. It also interacts with existing provisions that may require certain emergency or limited services regardless of immigration status (subject to the 1903(v)(2) carve-out).The text provided is the introduced version and reflects a proposed statutory change. It is not enacted law.The “color of law” phrase and references to specific sections (1902(a), 1903(v)(2), 1903(v)(4)) indicate that the bill relies on existing definitions and carve-outs within the Social Security Act to delineate what counts as eligible or ineligible medical benefits. The 1903(v)(2) carve-out is preserved, but the precise scope depends on current law.

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