Medicaid for immigrants — guide by immigration status

Medicaid for immigrants in the US

Medicaid is the health insurance program for low-income individuals, jointly funded by federal government and states. Eligibility rules for immigrants are complex and vary significantly by state.

Federal eligibility rules

Federally qualified (no special restriction)

• US citizens and US nationals
• Permanent residents (green card) with 5+ years (5-year bar)
• Cuban/Haitian entrants and COFA migrants (no 5-year bar)
• Through September 30, 2026 only — refugees, asylees, people paroled for at least 1 year, trafficking victims (T status) and qualifying VAWA self-petitioners (8 U.S.C. 1641). Through September 30, 2026, refugees, asylees and trafficking victims were exempt from the 5-year bar and federally funded; parolees and VAWA self-petitioners are qualified noncitizens but generally wait five years (8 U.S.C. 1613), and U visa holders are not qualified noncitizens. Since October 1, 2026 federal money no longer pays for their full Medicaid: Public Law 119-21, sec. 71109 limits federal financial participation to citizens and nationals, LPRs, Cuban/Haitian entrants and COFA migrants. See the October 1, 2026 section below before relying on this line.

Categories exempt from 5-year bar

• Children under 21 and pregnant women — only in the states that elected the CHIPRA 214 option. Per CMS’s table as of April 2, 2026, that covers children in 37 states, DC and 3 territories, and pregnant women in 31 states, DC and 3 territories. Elsewhere a child or pregnant woman who is subject to the five-year wait still has to meet it, unless another exception in 8 U.S.C. 1613(b) applies — for example Cuban/Haitian entrants, COFA migrants, and lawful permanent residents who are veterans or active-duty service members, or certain of their family members (CMS SHO #26-001).

Do NOT qualify federally

• Undocumented individuals
• DACA recipients (excluded by current rule)
• Temporary visas (tourist, F-1 student, H-1B in many cases)

State variation

41 states, including DC, have adopted ACA Medicaid expansion; 10 states have not (per KFF tracking, verified July 27, 2026 — territories like Puerto Rico run separate capped Medicaid programs outside the expansion framework). Per KFF, expansion extended Medicaid to nearly all adults with incomes up to 138% of the federal poverty level; the immigration-status rules above still apply. Some states extend coverage to undocumented individuals with state funds:

Table verified September 10, 2026 against the state sources: Illinois — HFS, Health Benefits for Immigrant Adults; Minnesota — Minn. Stat. 256L.04; California — Cal. Welf. & Inst. Code 14007.8; District of Columbia — DHCF, Health Care Alliance Program Changes and its stakeholder resource document. These are state-funded programs: the October 1, 2026 federal funding change described below does not create or remove any of them, but a state cutting its own budget can, and the Illinois, Minnesota, California and District of Columbia cells all changed in 2025 or 2026. What each state funds regardless of status is rendered from our dataset on every state page.

The October 1, 2026 change to federal funding

Section 71109 of the 2025 law (H.R.1 / WFTC, Public Law 119-21) is written as a limit on federal payment, but CMS told states that beginning October 1, 2026 they must limit eligibility determinations for full Medicaid and CHIP to people for whom federal funding is available. It changes who the federal government will pay for — and for Medicaid that difference decides whether coverage survives. CMS explained it to the states in letter SHO #26-001 (April 8, 2026).

Who federal money still covers, beginning October 1, 2026: U.S. citizens and U.S. nationals, lawful permanent residents, Cuban/Haitian entrants, and COFA migrants — provided the person is a resident of one of the 50 states, DC or a U.S. territory.

Who it stops covering, in CMS’s own words:

“Given these changes, beginning October 1, 2026, with limited exceptions, FFP will no longer be available for full Medicaid or CHIP benefits furnished to qualified noncitizens who are not also FFP-eligible noncitizens (e.g., asylees, refugees, parolees, or victims of trafficking) unless they have another immigration status or category that meets the definition of an FFP-eligible noncitizen.”

The three exceptions, and only three. CMS: “Section 1903(v)(5) of the Act describes only three exceptions to these FFP limitations” — (1) care and services necessary to treat an emergency medical condition (Emergency Medicaid), (2) coverage under the CHIPRA 214 option, and (3) Health Services Initiatives.

• Emergency Medicaid does not change. CMS: “section 1903(v)(5) of the Act did not make any changes to coverage of emergency Medicaid authorized under section 1903(v)(2) of the Act.” For Medicaid applicants who are not FFP-eligible noncitizens and not eligible under CHIPRA 214, “FFP remains available for emergency Medicaid coverage for such individuals … on and after October 1, 2026.”
• CHIPRA 214 can save children and pregnant women — where the state elected it. CMS: “If an applicant, who is not an FFP-eligible noncitizen, is a lawfully residing child or pregnant woman (e.g., a refugee) and meets all other eligibility requirements in the state, the applicant can be determined eligible for full Medicaid or CHIP benefits under the state’s CHIPRA 214 option.”

The five-year bar is untouched. The law did not amend PRWORA’s definitions or the waiting period: states “must continue to apply the five-year waiting period to LPRs” and must continue to except Cuban/Haitian entrants and COFA migrants from it.

States are not required to pay instead. CMS “will not require states to provide state-only funded health coverage to qualified noncitizens for whom FFP is not available,” and adds that it “would not consider health coverage that a state opts to continue to provide with 100 percent state-only funds to be Medicaid.”

What CMS does not say. CMS publishes no list of states that will or will not keep covering refugees, asylees, parolees and trafficking victims with their own money after October 1, 2026, and does not say what any one state will do. We do not infer it either way — ask your state Medicaid agency. CMS also notes that the eligibility regulations still on the books will not match the new funding rule, and that it “plan[s] to update Medicaid and CHIP regulations in future notice and comment rulemaking.”

For pregnancy and childbirth specifically, see who pays for prenatal care and the birth without immigration status.

For refugees, asylees and other ORR-eligible groups a state finds not eligible for Medicaid or CHIP, 45 CFR 400.94(d) sends the case to a Refugee Medical Assistance determination — see Refugee Cash and Medical Assistance (RCA/RMA), which ORR set at 12 months for eligibility dates on or after January 1, 2026 (Federal Register correction of October 1, 2026).

State pages

See Medicaid in your state for state-specific details.

Emergency services (Emergency Medicaid)

For medical emergencies, hospitals MUST treat any person regardless of immigration status under EMTALA. If the person has no insurance, the hospital can bill the patient or use Emergency Medicaid to cover emergency treatment.

Emergency Medicaid covers only medical emergencies (includes childbirth). Does not cover ongoing preventive care.

Because of that split, a pregnancy raises two separate coverage questions rather than one — the delivery is backed by a federal duty in every state, while routine prenatal care depends on a CHIP option each state elects or does not: see who pays for prenatal care and the birth without immigration status.

Official source: Medicaid.gov Eligibility

Last verified: 2026-09-24.

General procedural information for educational purposes. Not legal, tax, or immigration advice. Laws and fees change — verify with the issuing agency before taking action. For case-specific guidance, consult a licensed immigration attorney or other appropriate professional.

Related procedural information

• ITIN — required for tax-funded benefits — most benefits use SSN or ITIN for eligibility
• Federal benefits eligibility by immigration status — overview of who qualifies for what
• Find legal aid in your state — public-benefits attorneys help with appeals
• Consulate of your country — many consulates offer financial-assistance referrals
• Know Your Rights — public-benefits enrollment safety — agency confidentiality limits