States that extend Medicaid coverage to individuals without legal status will receive fewer federal Medicaid dollars if budget legislation passed by the House of Representatives is finalized, according to KFF.
The legislation would reduce federal Medicaid funding matches to 80% instead of 90% for states that extend coverage to individuals regardless of immigration status. Currently, 14 states and the District of Columbia provide Medicaid coverage to undocumented children, and seven states extend coverage to undocumented adults.
The House passed the “One Big Beautiful Bill” on May 22. The bill includes significant cuts to Medicaid, and faces further debate in the Senate.
According to a KFF analysis published May 22, if states choose to maintain this coverage, it will shift $92 billion in costs from the federal to state governments.
If states choose to eliminate coverage for undocumented immigrants, around 1.9 million people could lose Medicaid coverage, KFF estimated.
Federal Medicaid funds generally only cover emergency care for undocumented individuals, but some states have used state funding to expand this coverage. On May 27, CMS said it is ramping up oversight of these states to ensure no federal funds are misused.
Here’s how much federal funding each state could lose if they maintain coverage for undocumented individuals, according to KFF:
- California: $30 billion
- New York: $16 billion
- Illinois: $10 billion
- Washington: $10 billion
- New Jersey: $6 billion
- Oregon: $5 billion
- Massachusetts: $3 billion
- Minnesota: $3 billion
- Colorado: $3 billion
- Connecticut: $3 billion
- Utah: $1 billion
- Rhode Island: $782 million
- District of Columbia: $715 million
- Maine: $700 million
- Vermont: $300 million
Read the full report here.
