119-s2244

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2244 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 2244

To require immediate changes to Medicaid relating to alien eligibility 
 and payments to Medicaid expansion States that furnish health care to 
 certain aliens.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 July 10, 2025

 Mr. Paul introduced the following bill; which was read twice and 
 referred to the Committee on Finance

_______________________________________________________________________

 A BILL

To require immediate changes to Medicaid relating to alien eligibility 
 and payments to Medicaid expansion States that furnish health care to 
 certain aliens.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Excluding Illegal Aliens from 
Medicaid Act''.

SEC. 2. CHANGE OF EFFECTIVE DATE FOR ALIEN MEDICAID ELIGIBILITY.

    (a) In General.--

Section 1903
            (v) (5) of the Social Security Act (42 
U.S.C. 1396b
            (v) (5) ), as added by 

section 71109

    (a) of an Act to provide 
for reconciliation pursuant to title II of H. Con. Res. 14 (Public Law 
119-21), is amended by striking ``October 1, 2026'' and inserting 
``July 4, 2025''.

    (b) Effective Date.--The amendment made by subsection

    (a) shall 
take effect as if included in the enactment of 

section 71109 of an Act 
to provide for reconciliation pursuant to title II of H. Con. Res. 14 
(Public Law 119-21).

SEC. 3. EXPANSION FMAP FOR CERTAIN STATES PROVIDING PAYMENTS FOR HEALTH 
 CARE FURNISHED TO CERTAIN INDIVIDUALS.

 

Section 1905 of the Social Security Act (42 U.S.C. 1396d) is 
amended--

    (1) in subsection

    (y) --
        (A) in paragraph

    (1)
        (E) , by inserting ``(or, for 
 calendar quarters beginning on or after July 4, 2025, 
 in the case such State is a specified State with 
 respect to such calendar quarter, the Federal medical 
 assistance percentage determined under subsection

    (b) for such State)'' after ``thereafter''; and
        (B) in paragraph

    (2) , by adding at the end the 
 following new subparagraph:
 ``
            (C) Specified state.--The term `specified State' 
 means, with respect to a quarter, a State that--
 ``
            (i) provides any form of financial 
 assistance from a State general fund during 
 such quarter, in whole or in part, whether or 
 not made under a State plan (or waiver of such 
 plan) under this title or under another program 
 established by the State, to or on behalf of an 
 alien who is not a qualified alien and is not a 
 child or pregnant woman who is lawfully 
 residing in the United States and eligible for 
 medical assistance pursuant to 

section 1903
            (v) (4) or for child health assistance or 
 pregnancy-related assistance pursuant to 
 

section 2107

    (e)

    (1)
        (Q) , for the purchasing of 
 health insurance coverage (as defined in 
 

section 2791

    (b)

    (1) of the Public Health Service 
 Act) for an alien who is not a qualified alien 
 and is not such a child or pregnant woman; or
 ``
            (ii) provides any form of comprehensive 
 health benefits coverage, except such coverage 
 required by Federal law, during such quarter, 
 whether or not under a State plan (or waiver of 
 such plan) under this title or under another 
 program established by the State, and 
 regardless of the source of funding for such 
 coverage, to an alien who is not a qualified 
 alien and is not such a child or pregnant 
 woman.
 ``
            (D) Immigration terms.--
 ``
            (i) Alien.--The term `alien' has the 
 meaning given such term in 

section 101

    (a) of 
 the Immigration and Nationality Act.
 ``
            (ii) Qualified alien.--The term 
 `qualified alien' has the meaning given such 
 term in 

section 431 of the Personal 
 Responsibility and Work Opportunity 
 Reconciliation Act of 1996, except that the 
 references to `(in the opinion of the agency 
 providing such benefits)' in subsection
            (c) of 
 such 

section 431 shall be treated as references 
 to `(in the opinion of the State in which such 
 comprehensive health benefits coverage or such 
 financial assistance is provided, as 
 applicable)'.''; and

    (2) in subsection

    (z)

    (2) --
        (A) in subparagraph
        (A) , by striking ``for such 
 year'' and inserting ``for such quarter''; and
        (B) in subparagraph
        (B)
            (i) --
            (i) in the matter preceding subclause
            (I) , 
 by striking ``for a year'' and inserting ``for 
 a calendar quarter in a year''; and
            (ii) in subclause
            (II) , by striking ``for 
 the year'' and inserting ``for the quarter for 
 the State''.
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