Prohibiting Federal financial participation under Medicaid and CHIP for individuals without verified citizenship, nationality, or satisfactory immigration status

(a) In general (1) Medicaid Section 1903(i)(22) of the Social Security Act (42 U.S.C. 1396b(i)(22)) is amended— (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 individual 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 (iii) the period in which the individual is provided the reasonable opportunity to submit evidence indicating a satisfactory immigration status under section 1137(d)(4), amounts expended for such medical assistance, unless the citizenship or nationality of such individual or the satisfactory immigration status of such individual (as applicable) is verified by the end of such period;. (2) CHIP Section 2107(e)(1)(O) of the Social Security Act (42 U.S.C. 1397gg(e)(1)(O)) is amended by striking and (17) and inserting (17), and (22). (b) Eliminating State requirement to provide medical assistance during reasonable opportunity 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 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. (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 period) and inserting and, if the State has elected the option under subsection (a)(46)(C), continues to provide the individual 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 applicable 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 inserting under section 1137(d)(4); and (ii) by inserting, except that the State shall not be required to make medical 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 immigration status Section 1137(d)(4) of the Social Security Act (42 U.S.C. 1320b–7(d)(4)) is amended— (A) in subparagraph (A)(ii), by inserting (except that such prohibition on delay, denial, reduction, or termination of eligibility for benefits 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 benefits under the Medicaid program under title XIX shall apply only if the State has elected the option under section 1902(a)(46)(C)) after status. (c) Option to continue providing medical assistance during reasonable opportunity period (1) Medicaid Section 1902(a)(46) of the Social 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 subparagraph (B) during the period in which such individual 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 (ii) to an individual who is not a citizen or national of the United States during the period in which such individual is provided the reasonable opportunity to submit evidence indicating 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 subparagraph: (C) Option to continue providing child health assistance during reasonable 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 October 1, 2026.