I 
119TH CONGRESS 
1ST SESSION H. R. 4384 
To require immediate changes to Medicaid relating to alien eligibility and 
payments to Medicaid expansion States that furnish health care to cer-
tain aliens. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 14, 2025 
Mr. STEUBE introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
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 Representa-
tives 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 
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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 enact-
ment of section 71109 of an Act to provide for reconcili-
ation pursuant to title II of H. Con. Res. 14 (Public Law 
119–21). 
SEC. 3. EXPANSION FMAP FOR CERTAIN STATES PRO-
VIDING PAYMENTS FOR HEALTH CARE FUR-
NISHED 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 deter-
mined under subsection (b) for such State)’’ 
after ‘‘thereafter’’; and 
(B) in paragraph (2), by adding at the end 
the following new subparagraph: 
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‘‘(C) SPECIFIED STATE.—The term ‘speci-
fied State’ means, with respect to a quarter, a 
State that— 
‘‘(i) provides any form of financial as-
sistance 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 an-
other program established by the State, to 
or on behalf of an alien who is not a quali-
fied alien and is not a child or pregnant 
woman who is lawfully residing in the 
United States and eligible for medical as-
sistance pursuant to section 1903(v)(4) or 
for child health assistance or pregnancy-re-
lated 
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 comprehen-
sive health benefits coverage, except such 
coverage required by Federal law, during 
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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 Rec-
onciliation 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 ref-
erences 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)— 
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(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’’. 
Æ 
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