Ensuring Medicaid Eligibility Act of 2025

Ensuring Medicaid Eligibility Act of 2025

This bill establishes additional requirements for state Medicaid programs with respect to verifying the eligibility of enrollees, particularly for noncitizens. It also prohibits federal Medicaid payment for services for certain noncitizens who are temporarily admitted into the United States.

The bill prohibits implementation of the rule titled Medicaid Program; Streamlining the Medicaid, Children's Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes, which was issued by the Centers for Medicare & Medicaid Services on April 2, 2024.

Specifically, the bill prohibits implementation of provisions that, among other changes, (1) allow state Medicaid programs to verify an individual’s U.S. citizenship and identity through certain systems without additional proof of identity; (2) align certain Medicaid enrollment processes for those whose eligibility is not based on income with those that are based on income; and (3) establish additional timelines for Medicaid eligibility terminations, including when there is a change in an individual’s circumstances.

The bill also requires state Medicaid programs to (1) verify an individual's citizenship or immigration status prior to enrolling the individual in Medicaid; and (2) for individuals who qualify for Medicaid based on income, verify the individual's income on at least a quarterly basis while enrolled.

Finally, the bill prohibits federal Medicaid payment for services provided to noncitizens granted parole, asylum, Temporary Protected Status, withholding of removal, or deferred action, including Deferred Action for Childhood Arrivals (DACA) recipients.

Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov