The MediKids Act establishes a federally funded, nationwide Medicaid eligibility category for all individuals under age 26, featuring automatic enrollment at birth, continuous coverage, and expanded access regardless of immigration status.
Andy Kim
Senator
NJ
The MediKids Act establishes a nationwide Medicaid eligibility category for all individuals under age 26, ensuring comprehensive health coverage regardless of immigration status. The bill mandates automatic enrollment at birth, provides continuous eligibility, and guarantees full federal funding for states. Additionally, it expands access to essential pediatric services and exempts all young adults from work or community engagement requirements.
MediKids Act Mandates Automatic Enrollment and 100% Federal Funding for All Under 26
The MediKids Act is a massive shift in how young people in America get healthcare. In short, it creates a new Medicaid category specifically for everyone under the age of 26. Starting two years after this bill hits the books, states will be required to cover anyone in this age bracket, regardless of their immigration status (Section 1903(v)). To make this happen without breaking state budgets, the federal government is stepping up to cover 100% of the costs for new enrollees (Section 1905). This isn't just a minor expansion; it’s a fundamental change that treats healthcare for young adults as a baseline guarantee rather than a patchwork of employer plans and marketplace subsidies.
The "Newborn" Standard and Continuous Coverage
One of the most significant changes is the move to automatic enrollment. Under the new Section 1902(e)(4), any child born in the U.S. will be automatically enrolled in MediKids at birth. Parents will get a notice explaining the benefits and how to use them, but the default is "in" rather than "out." If a family already has private insurance, they can opt out, but they have to prove the other plan meets the Essential Health Benefits standards of the ACA. Once a kid is in, they stay in. The bill extends "continuous eligibility" until age 26 (Section 1902(e)(12)), meaning young adults won't have to constantly re-verify their income or paperwork to keep their doctor, providing a massive safety net for those graduating college, starting trade apprenticeships, or jumping between gig-economy jobs.
More Than Just a Card in Your Wallet
This bill doesn't just hand out insurance cards; it expands what that insurance actually covers. It raises the age for mandatory Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services from 21 to 26 (Section 1905(a)(4)(B)). For a 24-year-old worker, this means access to comprehensive screenings and treatments that were previously reserved for children. Furthermore, the bill explicitly bans states from applying work or community engagement requirements to anyone under 26 (Section 1902(xx)). Whether you are a full-time student or working three part-time jobs, your health coverage isn't tied to a timesheet.
Flexibility for the Marketplace
For those who prefer to stick with private plans or marketplace options, the bill includes a "no double-dipping" but "no penalty" clause. If you are eligible for MediKids but choose not to enroll, you aren't considered to have "minimum essential coverage" for the purposes of the tax code (Section 36B(c)(2)(D)). This sounds like jargon, but it’s actually a win for consumer choice: it means you can still qualify for premium tax credits to buy a private plan on the ACA marketplace if you decide MediKids isn't for you. It ensures that being eligible for a government program doesn't accidentally lock you out of subsidies for private insurance.