H.R. 4209 — No Medicaid for Illegals Act

This section prohibits federal financial participation for Medicaid and CHIP expenditures on medical assistance provided during reasonable opportunity periods—including the 90-day period under section 1902(ee)(1)(B)(ii)(II)—to verify an individual's U.S. citizenship or nationality or satisfactory immigration status, unless such status is verified by the end of the period. (As background, Medicaid and CHIP generally require U.S. citizenship or qualifying immigration status for full eligibility, with current law allowing states to provide temporary coverage during specified verification periods while receiving federal funding.) It also eliminates the requirement that states provide such medical assistance during those periods under sections 1903(x)(4), 1902(ee), and 1137(d)(4); instead, it establishes continued provision of assistance during those periods as an optional state election under new section 1902(a)(46)(C) (applied to CHIP via section 2105(c)(9)(C)). (Thus, states may elect not to provide coverage during verification periods, avoiding uncompensated state costs for unverified individuals.) The amendments apply beginning on the date of enactment.