How States Verify Citizenship and Immigration Status in Medicaid

Medicade US Medicade has a primary program providing extensive coverage of health and long -term care to 83 million low -income people, jointly funded by states and federal government, but has been administered by states within wide federal rules. In addition to meeting federal and state income and habitat requirements, eligibility for coverage under Medicade and children’s health insurance program (chip) is limited to American citizens and some legally existing migrants. Federal Medicade Funds cannot be used to cover unspecified immigrants. Unwarded immigrants are also excluded from other union-funded health programs, including Medicare and Affordable Care Act Marketplace.

On February 19, 2025, the Trump administration issued an executive order for “Open Borders Taxpayer Subsidy”, including the taxpayer to call a language call for increased verification systems to ensure the benefits funded by the taxpayer, which require federal agencies and need to identify the sources of federal funding for unwarded immigrants. States require states to verify a qualified immigration status through the Homeland Security Department (DHS) Department as part of the process to determine the current federal rules. Despite these requirements, the Republican at the Congress has introduced a law to prevent state Medicade programs from covering unwarded immigrants. There is also public confusion about the eligibility of immigrants for federal programs, either uncertain or incorrectly believing with less than half of adults are eligible for health insurance programs paid to the non -resident federal government. This brief federal citizenship and immigration status describes eligibility and eligibility verification requirements for medicid.

What are Medicade eligibility requirements for immigrants?

Federal Rules Medicade and Children’s Health Insurance Program (CHIP) eligibility for American citizens and some legally present ImmigrantsNot eligible for coverage of uninterrupted non-resident union-funded coverageIn general, in addition to meeting other eligibility requirements, legally existing migrants must have a “qualified non-neurological” status to be eligible for the Medicid or Chip (Table 1), and many, including most legitimate permanent residents or “green cards” holders, should wait for five years before obtaining a qualified position. These immigrants can enroll in market coverage and get subsidy during this five -year waiting period. Some immigrants with qualified conditions, such as Asylees and Refugees, do not need to wait for five years to enroll in medicade and chip coverage. Some immigrants, such as temporary protected positions, duly exist, but do not have a worthy situation and are not eligible for medicade and chip coverage even after five years of waiting. A person with a deferred action for childhood arrival (DACA) is not eligible for a medicade or chip, and the implementation of a market coverage expansion for them is subject to the ongoing litigation. States have the option to cover children and pregnant people in a medicade or chip without a five -year waiting period, known as the immigrant Children’s Health Improvement Act (ICHIA) option. The state can also provide benefits related to prenatal care and pregnancy to low-income children initiated for conception from conception from the chip, regardless of their parents’ citizenship or immigration status. Some states provide fully funded coverage to fill the gaps in coverage for immigrants, including legitimately current immigrants and uninterrupted immigrants.

Emergency Medicade reimbursed hospitals for emergency care provided to unqualified persons due to its immigration statusIn reimbursement hospitals for emergency care -cost emergency care, they are obliged to provide other Medicade eligibility requirements (such as income) to individuals, but do not have a eligible immigration status, which includes unproven immigrants and legitimate migrants who are unqualified for medicid or chip. Emergency services require immediate attention to prevent death, severe loss or disability, although states have some discretion to determine reimbileable services. Spending on emergency Medicade accounts for less than 1% of the total medicine expenditure. Without emergency Medicade, the cost of emergency care will be transferred to hospitals that are required to treat individuals in emergency situations or completely states.

How to verify state citizenship and immigration status to determine medicade eligibility?

States should verify the citizenship and immigration status with Social Security Administration (SSA) and DHS to determine eligibility for medicid coverage on preliminary applicationApplicants who are American citizens must provide citizenship document, or states to verify the social security number of the applicant with SSA. Applicants who are not American citizens will have to provide documents showing that they have a qualified immigration status qualified for Medicade coverage (Figure 1). State DHS for state entitlements (sev) system verification the immigration status through systematic foreign verification, which can provide automatic real -time verification. If the system cannot provide real -time verification, DHS employees do an additional review and request documentation of eligible immigration status. Applicants cannot self-fulfill to having a qualified immigration position without documentation to the state, exempting five years waiting due to a military connection with the exception of qualified immigrants. Current federal rules prevent the states from disclosing the immigration status of non-applicants, such as domestic members, who are not relevant to eligibility determination, and the safety system cannot be used for non-exemption immigration enforcement.

States need to provide medicid benefits during a “one” applicants.Appropriate opportunity period“During 90 days, while their immigration situation is being verified, if they otherwise meet all eligibility criteriaAppropriate opportunity periods are allowed when the safety system cannot verify the immigration status in real time and the state needs to collect additional documents to review additional reviews and to verify the qualified immigration status. This period gives applicants an opportunity to correct information in saving or submitting additional documents in support of their application. States can expand this period if they require more time to complete verification or if applicants are trying to correct issues with the document. The state is entitled to receive federal matching funds for expenditure for medicid services provided to individuals during the appropriate opportunity period, even if the eligibility is eventually verified. If the states disqualify an applicant for medicade coverage due to their immigration position at any point during the appropriate opportunity period, they have to eliminate the eligibility within 30 days. This can also happen when applicants do not provide additional requested documents or do not correct any discrepancies in the application. Applicants have the right to dispute the state’s decision in the fair hearing process, but the states do not need to provide medicade benefits during this period.

In some cases, the states need to re -prepare the immigration status as part of the Medicade Annual Recovery of Eligibility Processes.States do not need to re -verify the immigration status for most enroll during annual renovation if that condition is unlikely to change (eg, Enrolli is a valid permanent resident). However, immigrant children and pregnant people, who have been living in the US for less than five years to get coverage through Ichia option, must re -verify their immigration status in renewal. If, at any point during the coverage period, the state receives information about the change in the immigration status of Enrollie that can affect the ongoing eligibility, the state needs to work on the situation in the situation to review the eligibility and request additional documents from Enroll if necessary.