This bill prohibits the implementation of a specific Medicaid streamlining rule, mandates citizenship/immigration verification before Medicaid enrollment, requires quarterly income checks for some enrollees, and eliminates federal Medicaid funding for parolees, DACA, and TPS recipients.
Mike Kennedy
Representative
UT-3
The Ensuring Medicaid Eligibility Act of 2025 blocks a specific 2024 rule aimed at streamlining Medicaid processes. This bill mandates that citizenship or satisfactory immigration status must be verified before enrollment in Medicaid can occur. Furthermore, it requires quarterly income re-verification for certain enrollees and prohibits federal Medicaid funding for medical services provided to parolees, TPS, and DACA recipients.
New Medicaid Bill Blocks Enrollment Streamlining, Mandates Quarterly Income Checks, and Cuts Coverage for DACA and TPS Holders
The “Ensuring Medicaid Eligibility Act of 2025” isn’t about expanding healthcare access; it’s about tightening the gate on who gets in and how often they have to prove they still belong there. This bill makes major changes to how people apply for and keep Medicaid, focusing heavily on verification and exclusion.
Hitting the Brakes on Modernization
First up, Section 2 of the bill immediately slams the brakes on a proposed rule called the “Medicaid Program: Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes.” This rule, published back in April 2024, was supposed to simplify the paperwork and administrative headaches involved in getting and keeping coverage. By blocking it, the bill ensures that whatever existing, often complicated, application and renewal processes are currently in place will remain. For the busy parent trying to re-enroll their kids in CHIP during a lunch break, this means no relief from the current bureaucratic maze.
Mandatory Verification Before Coverage Begins
Section 3 adds two significant hurdles for applicants. Currently, some states can grant temporary coverage while citizenship or immigration status is being verified, ensuring people get care when they need it. This bill changes that: states are now prohibited from enrolling anyone in Medicaid until their U.S. citizenship, U.S. national status, or “satisfactory immigration status” is fully confirmed. This pre-enrollment verification requirement could be a major problem for eligible people—think of a naturalized citizen whose paperwork is stuck in bureaucratic limbo, or an eligible immigrant whose status verification takes months. They now have to wait for the system to catch up before they can see a doctor.
The Quarterly Income Treadmill
Section 3 also introduces a new administrative burden: quarterly income checks. If your Medicaid eligibility is based on your income, the state must now re-verify that income every three months. For people working hourly jobs or juggling multiple part-time gigs, income often fluctuates. This new requirement means that if a person’s income briefly spikes one month—maybe due to overtime or a small bonus—they could be cycled off coverage, only to have to reapply when their income drops again. This creates instability in healthcare access and adds significant, constant administrative work for state Medicaid offices.
Cutting Off Coverage for Specific Immigrant Groups
The most impactful provision is found in Section 4, which targets specific immigrant groups for exclusion from federally funded Medicaid. The bill amends the Social Security Act to explicitly stop the federal government from reimbursing states for medical services provided to several categories of non-citizens, including those granted parole, those with Deferred Action (like DACA recipients), and those holding Temporary Protected Status (TPS). For someone with TPS who has lived and worked here for years, this bill means their access to federally subsidized health coverage is immediately cut off, even if they meet all other income requirements. The bill requires states to update their own coverage rules to exclude these groups entirely, shifting the cost burden onto states or, more likely, onto the individuals themselves, who will become uninsured.
The Real-World Impact
In short, this legislation makes it harder, slower, and more precarious to get and keep Medicaid coverage. It blocks administrative improvements, mandates new verification delays, and imposes frequent income checks that could lead to constant coverage interruptions. Most critically, it explicitly removes federal support for healthcare coverage for thousands of individuals who are legally present and working in the country under specific statuses like DACA and TPS, forcing them and the systems that serve them to absorb the cost of their medical needs.