This bill accelerates the exclusion of undocumented immigrants from federal Medicaid coverage by moving the effective date from October 1, 2026, to July 4, 2025. It also penalizes states that use their own funds to provide health insurance or comprehensive health coverage to undocumented immigrants by reducing their federal Medicaid matching funds—meaning the federal government would reimburse those states at a lower rate for their Medicaid programs. The bill defines "specified states" as those providing any form of state-funded health assistance or comprehensive coverage to undocumented immigrants (with limited exceptions for children and pregnant women). This legislation affects Medicaid expansion states that currently provide health coverage to undocumented residents and would immediately change which immigrants qualify for federally-funded Medicaid benefits, with financial consequences for states that choose to maintain coverage using their own resources.
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