I 

118TH CONGRESS 

2D SESSION H. R. 7014 

To amend title XIX of the Social Security Act to prohibit Federal Medicaid 

funding for the administrative costs of providing health benefits to individuals who are unauthorized immigrants. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 17, 2024 

Mr. HUDSON (for himself, Mr. GUTHRIE, and Mr. CALVERT) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to prohibit 

Federal Medicaid funding for the administrative costs 

of providing health benefits to individuals who are unauthorized immigrants. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protect Medicaid Act’’. 


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1 SEC. 2. PROHIBITING FEDERAL MEDICAID FUNDING FOR 

2 THE ADMINISTRATIVE COSTS OF PROVIDING 

3 HEALTH BENEFITS TO INDIVIDUALS WHO 

4 ARE UNAUTHORIZED IMMIGRANTS. 

5 Section 1903(i) of the Social Security Act (42 U.S.C. 

6 1396b(i)) is amended— 

7 (1) in paragraph (26), by striking ‘‘; or’’ and 

8 inserting a semicolon; 

9 (2) in paragraph (27), by striking the period at 

10 the end and inserting ‘‘; or’’; and 

11 (3) by inserting after paragraph (27) the fol12 lowing new paragraph: 

13 ‘‘(28) with respect to any amounts expended for 

14 the administration of a State program associated 

15 with providing health benefits to noncitizens who are 

16 not lawfully admitted permanent residents and are 

17 ineligible for medical assistance under this title on 

18 the basis of not having a satisfactory immigration 

19 status (as defined in section 1137(d)(1)(B)(iii)) (ex20 cept that such prohibition shall not be construed as 

21 prohibiting payment under the preceding provisions 

22 of this section for costs attributable to the establish23 ment or operation of a system designed to ensure 

24 compliance with such prohibition).’’. 


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1 SEC. 3. INSPECTOR GENERAL REPORT. 

2 Not later than 180 days after the date of enactment 

3 of this Act, the Inspector General of the Department of 

4 Health and Human Services shall submit to Congress a 

5 report that includes the following information with respect 

6 to States that provide health benefits to noncitizens who 

7 are not lawfully admitted permanent residents and are in8 eligible on the basis of immigration status for medical as9 sistance under title XIX of the Social Security Act (42 

10 U.S.C. 1396 et seq.): 

11 (1) How such States separate amounts ex12 pended on the administrative costs related to the 

13 State’s Medicaid program and amounts expended on 

14 administrative costs related to providing health ben15 efits to such noncitizens. 

16 (2) The types of procedures, protocols, or sys17 tems that such States employ to ensure that they 

18 are in full compliance with prohibitions on the use 

19 of Federal funding to provide health benefits to such 

20 noncitizens and how effective they are at ensuring 

21 compliance. 

22 (3) A description of States’ methods of financ23 ing State programs that provide health benefits to 

24 such noncitizens who are ineligible for medical as25 sistance due to not having a satisfactory immigra26 tion status, including through the increased use of 


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1 provider taxes and intergovernmental transfers to fi2 nance the non-Federal share of expenditures under 

3 the State Medicaid program for medical assistance 

4 provided to individuals who are not so ineligible. 

5 (4) An analysis of— 

6 (A) the extent to which such noncitizens 

7 are provided covered outpatient drugs pur8 chased under— 

9 (i) the Medicaid Drug Rebate Pro10 gram under section 1927 of the Social Se11 curity Act (42 U.S.C. 1396r–8); or 

12 (ii) the drug discount program under 

13 section 340B of the Public Health Service 

14 Act (42 U.S.C. 256b); and 

15 (B) the effect that the provision to such 

16 noncitizens of covered outpatient drugs pur17 chased under the programs described in sub18 paragraph (A) has on the average manufacturer 

19 price (as defined in section 1927(k)(1) of the 

20 Social Security Act (42 U.S.C. 1396r–8(k)(1))) 

21 of such drugs, including whether the average 

22 manufacturer price for such drugs would be 

23 lower if no drugs purchased under such pro24 grams were provided to such noncitizens. 

Æ 


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