I 
119TH CONGRESS 
1ST SESSION H. R. 4209 
To amend titles XIX and XXI of the Social Security Act to prohibit Federal 
financial participation under Medicaid and CHIP for individuals without 
verified citizenship, nationality, or satisfactory immigration status. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 26, 2025 
Mr. VAN DREW introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend titles XIX and XXI of the Social Security Act 
to prohibit Federal financial participation under Med-
icaid and CHIP for individuals without verified citizen-
ship, nationality, or satisfactory immigration status. 
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 ‘‘No Medicaid for 
Illegals Act’’. 
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SEC. 2. PROHIBITING FEDERAL FINANCIAL PARTICIPATION 
UNDER MEDICAID AND CHIP FOR INDIVID-
UALS WITHOUT VERIFIED CITIZENSHIP, NA-
TIONALITY, OR SATISFACTORY IMMIGRATION 
STATUS. 
(a) IN GENERAL.— 
(1) MEDICAID.—Section 1903(i)(22) of the So-
cial Security Act (42 U.S.C. 1396b(i)(22)) is amend-
ed— 
(A) by adding ‘‘and’’ at the end; 
(B) by striking ‘‘to amounts’’ and inserting 
‘‘to— 
‘‘(A) amounts’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(B) in the case that the State elects 
under section 1902(a)(46)(C) to provide for 
making medical assistance available to an indi-
vidual during— 
‘‘(i) the period in which the individual 
is provided the reasonable opportunity to 
present satisfactory documentary evidence 
of citizenship or nationality under section 
1902(ee)(2)(C) or subsection (x)(4); 
‘‘(ii) the 90-day period described in 
section 1902(ee)(1)(B)(ii)(II); or 
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‘‘(iii) the period in which the indi-
vidual is provided the reasonable oppor-
tunity to submit evidence indicating a sat-
isfactory immigration status under section 
1137(d)(4), 
amounts expended for such medical assistance, 
unless the citizenship or nationality of such in-
dividual or the satisfactory immigration status 
of such individual (as applicable) is verified by 
the end of such period;’’. 
(2) CHIP.—Section 2107(e)(1)(N) of the So-
cial Security Act (42 U.S.C. 1397gg(e)(1)(N)) is 
amended by striking ‘‘and (17)’’ and inserting 
‘‘(17), and (22)’’. 
(b) ELIMINATING STATE REQUIREMENT TO PRO-
VIDE MEDICAL ASSISTANCE DURING REASONABLE OP-
PORTUNITY PERIOD.— 
(1) DOCUMENTARY EVIDENCE OF CITIZENSHIP 
OR NATIONALITY.—Section 1903(x)(4) of the Social 
Security Act (42 U.S.C. 1396b(x)) is amended— 
(A) by striking ‘‘under clauses (i) and (ii) 
of section 1137(d)(4)(A)’’ and inserting ‘‘under 
section 1137(d)(4)’’; and 
(B) by inserting ‘‘, except that the State 
shall not be required to make medical assist-
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ance available to such individual during the pe-
riod in which such individual is provided such 
reasonable opportunity if the State has not 
elected 
the 
option 
under 
section 
1902(a)(46)(C)’’ before the period at the end. 
(2) SOCIAL SECURITY DATA MATCH.—Section 
1902(ee) of the Social Security Act (42 U.S.C. 
1396a(ee)) is amended— 
(A) in paragraph (1)(B)(ii)— 
(i) in subclause (II), by striking ‘‘(and 
continues to provide the individual with 
medical assistance during such 90-day pe-
riod)’’ and inserting ‘‘and, if the State has 
elected 
the 
option 
under 
subsection 
(a)(46)(C), continues to provide the indi-
vidual with medical assistance during such 
90-day period’’; and 
(ii) in subclause (III), by inserting ‘‘, 
or denies eligibility for medical assistance 
under this title for such individual, as ap-
plicable’’ after ‘‘under this title’’; and 
(B) in paragraph (2)(C)— 
(i) by striking ‘‘under clauses (i) and 
(ii) of section 1137(d)(4)(A)’’ and insert-
ing ‘‘under section 1137(d)(4)’’; and 
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(ii) by inserting ‘‘, except that the 
State shall not be required to make med-
ical assistance available to such individual 
during the period in which such individual 
is provided such reasonable opportunity if 
the State has not elected the option under 
section 1902(a)(46)(C)’’ before the period 
at the end. 
(3) INDIVIDUALS
WITH
SATISFACTORY
IMMI-
GRATION STATUS.—Section 1137(d)(4) of the Social 
Security Act (42 U.S.C. 1320b–7(d)(4)) is amend-
ed— 
(A) in subparagraph (A)(ii), by inserting 
‘‘(except that such prohibition on delay, denial, 
reduction, or termination of eligibility for bene-
fits under the Medicaid program under title 
XIX shall apply only if the State has elected 
the option under section 1902(a)(46)(C))’’ after 
‘‘has been provided’’; and 
(B) in subparagraph (B)(ii), by inserting 
‘‘(except that such prohibition on delay, denial, 
reduction, or termination of eligibility for bene-
fits under the Medicaid program under title 
XIX shall apply only if the State has elected 
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the option under section 1902(a)(46)(C))’’ after 
‘‘status’’. 
(c) OPTION TO CONTINUE PROVIDING MEDICAL AS-
SISTANCE
DURING
REASONABLE
OPPORTUNITY
PE-
RIOD.— 
(1) MEDICAID.—Section 1902(a)(46) of the So-
cial Security Act (42 U.S.C. 1396a(a)(46)) is 
amended— 
(A) in subparagraph (A), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (B)(ii), by adding 
‘‘and’’ at the end; and 
(C) by inserting after subparagraph (B)(ii) 
the following new subparagraph: 
‘‘(C) provide, at the option of the State, for 
making medical assistance available— 
‘‘(i) to an individual described in subpara-
graph (B) during the period in which such indi-
vidual is provided the reasonable opportunity to 
present satisfactory documentary evidence of 
citizenship or nationality under subsection 
(ee)(2)(C) or section 1903(x)(4), or during the 
90-day 
period 
described 
in 
subsection 
(ee)(1)(B)(ii)(II); or 
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‘‘(ii) to an individual who is not a citizen 
or national of the United States during the pe-
riod in which such individual is provided the 
reasonable opportunity to submit evidence indi-
cating a satisfactory immigration status under 
section 1137(d)(4);’’. 
(2) CHIP.—Section 2105(c)(9) of the Social 
Security Act (42 U.S.C. 1397ee(c)(9)) is amended 
by adding at the end the following new subpara-
graph: 
‘‘(C) OPTION
TO
CONTINUE
PROVIDING 
CHILD HEALTH ASSISTANCE DURING REASON-
ABLE
OPPORTUNITY
PERIOD.—Section 
1902(a)(46)(C) shall apply to States under this 
title in the same manner as it applies to a State 
under title XIX.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply beginning on the date of the enact-
ment of this Act. 
Æ 
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