striking subsection (d) and redesignating subsection 
(e) as subsection (d). 
(5) REQUIREMENT TO MAINTAIN MINIMUM ES-
SENTIAL
COVERAGE.—Subsection (d) of section 
5000A of the Internal Revenue Code of 1986 is 
amended by striking paragraph (3) and by redesig-
nating paragraph (4) as paragraph (3). 
(b) CONFORMING AMENDMENTS.— 
(1) ESTABLISHMENT
OF
PROGRAM.—Section 
1411(a) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18081(a)) is amended by strik-
ing paragraph (1) and redesignating paragraphs (2), 
(3), and (4) as paragraphs (1), (2), and (3), respec-
tively. 
(2) QUALIFIED INDIVIDUALS.—Section 1312(f) 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18032(f)) is amended— 
(A) in the heading, by striking ‘‘; ACCESS 
LIMITED
TO CITIZENS
AND LAWFUL RESI-
DENTS’’; and 
(B) by striking paragraph (3). 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to years, plan years, and taxable 
years, as applicable, beginning after December 31, 2023. 
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SEC. 6. STATE OPTION TO EXPAND MEDICAID AND CHIP TO 
INDIVIDUALS WITHOUT LAWFUL PRESENCE. 
(a) MEDICAID.— 
(1) IN
GENERAL.—Section 1902(a)(10)(A)(ii) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(10)(A)(ii)) is amended— 
(A) in subclause (XXII), by striking ‘‘or’’ 
at the end; 
(B) in subclause (XXIII), by striking the 
semicolon and inserting ‘‘; or’’; and 
(C) by adding at the end the following new 
subclause: 
‘‘(XXIV) who would be eligible 
under the State plan (or waiver of 
such plan) under this title if they were 
citizens of the United States;’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended, in the matter preceding para-
graph (1)— 
(A) in the matter designated as clause 
(xxvi), by striking ‘‘or’’ at the end; 
(B) in the matter designated as clause 
(xxvii), by adding ‘‘or’’ at the end; and 
(C) by inserting after the matter des-
ignated as clause (xxvii) the following: 
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‘‘(xxviii) 
individuals 
described 
in 
section 
1902(a)(10)(A)(ii)(XXIV),’’. 
(b) CHIP.—Title XXI of the Social Security Act (42 
U.S.C. 1397aa et seq.) is amended by inserting after sec-
tion 2112 the following new section: 
‘‘SEC. 2112A. STATE OPTION TO PROVIDE COVERAGE FOR 
INDIVIDUALS WITHOUT LAWFUL PRESENCE. 
‘‘A State may elect through an amendment to its 
State child health plan under section 2102 to treat an in-
dividual as a targeted low-income child or a targeted low- 
income pregnant woman for purposes of this title if such 
individual would otherwise be included as such a child or 
such a pregnant woman (as applicable) under such plan 
if the individual were a citizen of the United States.’’. 
(c) NONAPPLICATION
OF
ELIGIBILITY
PROHIBI-
TION.—Section 401(a) of the Personal Responsibility and 
Work Opportunity Reconciliation Act of 1996 (42 U.S.C. 
1611(a)) is amended by adding at the end the following 
new sentence: ‘‘The preceding sentence shall not apply 
with respect to a noncitizen’s eligibility under a State plan 
(or waiver of such plan) under title XIX of the Social Se-
curity Act or under a State child health plan (or waiver 
of such plan) under title XXI of such Act to the extent 
that such State has elected to make such individual so 
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eligible pursuant to section 1902(a)(10)(A)(ii)(XXIV) or 
2112A of such Act, respectively.’’. 
SEC. 7. PRESERVING ACCESS TO COVERAGE. 
(a) IN GENERAL.—Nothing in this Act, including the 
amendments made by this Act, shall prevent lawfully 
present noncitizens who are ineligible for full benefits 
under the Medicaid program under title XIX of the Social 
Security Act from securing a credit for which such lawfully 
present noncitizens would be eligible under section 
36B(c)(1)(B) of the Internal Revenue Code of 1986 and 
under the Medicaid provisions for lawfully present nonciti-
zens, as in effect on the date prior to the date of enact-
ment of this Act. 
(b) DEFINITION.—For purposes of subsection (a), 
the term ‘‘full benefits’’ means, with respect to an indi-
vidual and State, medical assistance for all services cov-
ered under the State plan under title XIX of the Social 
Security Act that is not less in amount, duration, or scope, 
or is determined by the Secretary of Health and Human 
Services to be substantially equivalent to the medical as-
sistance available for an individual described in section 
1902(a)(10)(A)(i) of the Social Security Act (42 U.S.C. 
1396a(a)(10)(A)(i)). 
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SEC. 8. REMOVING BARRIERS TO HEALTH COVERAGE FOR 
LAWFULLY PRESENT INDIVIDUALS IN MEDI-
CARE. 
(a) PART A.—Section 1818(a)(3) of the Social Secu-
rity Act (42 U.S.C. 1395i–2(a)(3)) is amended by striking 
‘‘an alien’’ and all that follows through ‘‘under this sec-
tion’’ and inserting ‘‘an individual who is lawfully present 
in the United States, including individuals with an ap-
proved or pending application for deferred action or other 
federally authorized presence’’. 
(b) PART B.—Section 1836(2) of the Social Security 
Act (42 U.S.C. 1395o(2)) is amended by striking ‘‘an 
alien’’ and all that follows through ‘‘under this part’’ and 
inserting ‘‘an individual who is lawfully present in the 
United States, including individuals with an approved or 
pending application for deferred action or other federally 
authorized presence’’. 
(c) LAWFULLY PRESENT DEFINED.—The term ‘‘law-
fully present’’ shall include, at a minimum, all immigra-
tion categories that are treated as lawfully present for pur-
poses of the title XIX program as amended by section 3. 
Æ 
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