SEC. 2. PROHIBITING FEDERAL MEDICAID FUNDING FOR 
THE ADMINISTRATIVE COSTS OF PROVIDING 
HEALTH BENEFITS TO INDIVIDUALS WHO 
ARE UNAUTHORIZED IMMIGRANTS. 
Section 1903(i) of the Social Security Act (42 U.S.C. 
1396b(i)) is amended— 
(1) in paragraph (26), by striking ‘‘; or’’ and 
inserting a semicolon; 
(2) in paragraph (27), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by inserting after paragraph (27) the fol-
lowing new paragraph: 
‘‘(28) with respect to any amounts expended for 
the administration of a State program that provides 
health benefits to noncitizens who are ineligible for 
medical assistance under this title on the basis of 
not having a satisfactory immigration status (as de-
fined in section 1137(d)(1)(B)(iii)) (except that such 
prohibition shall not be construed as prohibiting 
payment under the preceding provisions of this sec-
tion for costs attributable to the establishment or 
operation of a system designed to ensure compliance 
with such prohibition).’’. 
SEC. 3. INSPECTOR GENERAL REPORT. 
Not later than 180 days after the date of enactment 
of this Act, the Inspector General of the Department of 
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Health and Human Services shall submit to Congress a 
report that includes the following information with respect 
to States that provide health benefits to noncitizens who 
are ineligible on the basis of immigration status for med-
ical assistance under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.): 
(1) How such States separate amounts ex-
pended on the administrative costs related to the 
State’s Medicaid program and amounts expended on 
administrative costs related to providing health ben-
efits to such noncitizens. 
(2) The types of procedures, protocols, or sys-
tems that such States employ to ensure that they 
are in full compliance with prohibitions on the use 
of Federal funding to provide health benefits to such 
noncitizens and how effective they are at ensuring 
compliance. 
(3) A description of States’ methods of financ-
ing State programs that provide health benefits to 
noncitizens who are ineligible for medical assistance 
due to not having a satisfactory immigration status, 
including through the increased use of provider taxes 
and intergovernmental transfers to finance the non- 
Federal share of expenditures under the State Med-
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icaid program for medical assistance provided to in-
dividuals who are not so ineligible. 
(4) An analysis of— 
(A) the extent to which such noncitizens 
are provided covered outpatient drugs pur-
chased under— 
(i) the Medicaid Drug Rebate Pro-
gram under section 1927 of the Social Se-
curity Act (42 U.S.C. 1396r–8); or 
(ii) the drug discount program under 
section 340B of the Public Health Service 
Act (42 U.S.C. 256b); and 
(B) the effect that the provision to such 
noncitizens of covered outpatient drugs pur-
chased under the programs described in sub-
paragraph (A) has on the average manufacturer 
price (as defined in section 1927(k)(1) of the 
Social Security Act (42 U.S.C. 1396r–8(k)(1))) 
of such drugs, including whether the average 
manufacturer price for such drugs would be 
lower if no drugs purchased under such pro-
grams were provided to such noncitizens. 
Æ 
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