S. 2244 — Excluding Illegal Aliens from Medicaid Act

This section advances the effective date for the alien Medicaid eligibility provision to July 4, 2025 (from October 1, 2026).

This section reduces the enhanced federal medical assistance percentage (FMAP) for Medicaid expansion enrollees (i.e., adults up to 138% of the federal poverty level) in specified states to the state's regular FMAP under subsection (b) (from 90%) for calendar quarters beginning on or after July 4, 2025. (A specified state is one that provides state general fund financial assistance for purchasing health insurance coverage or any form of comprehensive health benefits coverage—except as required by federal law—to aliens who are not qualified aliens (i.e., generally lawful permanent residents, refugees, asylees, and certain others) and not lawfully residing children or pregnant women eligible for Medicaid or CHIP; the section also defines "alien" and "qualified alien" and makes related technical conforming changes.) (Thus, affected states receive lower federal matching funds for expansion populations, increasing state costs.) The section further makes technical changes in subsection (z)(2) to the increased FMAP for states recovering from major disasters by replacing annual references with calendar quarter references.