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Congressional Research Service
Version 00 · Introduced in House · Feb 11, 2025
Protect Medicaid Act
This bill prohibits federal payment under Medicaid for the administrative costs of providing health benefits to noncitizens who are ineligible for Medicaid based on their immigration status. The Department of Health and Human Services must report on specified information regarding states that provide health benefits to such individuals.
People & committees
Rep. Hudson, Richard [R-NC-9] · R–NC
Legislative record
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Referred to the House Committee on Energy and Commerce.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
Source last updated: Dec 5, 2025. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2025-02-11 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed Protect Medicaid Act would restrict federal Medicaid funding for state administrative costs associated with providing health benefits to certain noncitizens: those who are not lawful permanent residents and are ineligible for Medicaid because of immigration status. It would preserve payments for systems designed to ensure compliance with that restriction. It would also require a federal report on affected states’ accounting, financing, compliance practices, and use of federal drug programs.
This Act may be cited as the Protect Medicaid Act.
(28) with respect to any amounts expended for the administration of a State program associated with providing health benefits to noncitizens who are not lawfully admitted permanent residents and are ineligible for medical assistance under this title on the basis of not having a satisfactory immigration status (as defined in section 1137(d)(1)(B)(iii)) (except that such prohibition shall not be construed as prohibiting payment under the preceding provisions of this section for costs attributable to the establishment or operation of a system designed to ensure compliance with such prohibition).
the Inspector General of the Department of Health and Human Services shall submit to Congress a report
(1) How such States separate amounts expended on the administrative costs
(2) The types of procedures, protocols, or systems that such States employ
(3) A description of States' methods of financing State programs
(4) An analysis of— (A) the extent to which such noncitizens are provided covered outpatient drugs purchased under— (i) the Medicaid Drug Rebate Program under section 1927 of the Social Security Act (42 U.S.C. 1396r–8); or (ii) the drug discount program under section 340B of the Public Health Service Act (42 U.S.C. 256b);
Section 2 would add a federal Medicaid funding prohibition covering administrative expenses of state programs associated with health benefits for noncitizens meeting both conditions: they are not lawful permanent residents, and they are ineligible for Medicaid because they lack the immigration status required by the referenced law.
Prohibiting Federal Medicaid funding for the administrative costs of providing health benefits to individuals who are unauthorized immigrants Section 1903(i) of the Social Security Act (42 U.S.C. 1396b(i)) is amended—
(28) with respect to any amounts expended for the administration of a State program associated with providing health benefits to noncitizens who are not lawfully admitted permanent residents and are ineligible for medical assistance under this title on the basis of not having a satisfactory immigration status (as defined in section 1137(d)(1)(B)(iii))
The proposed restriction would allow payments otherwise available under the preceding provisions of the same statutory section for establishing or operating a system designed to ensure compliance with the restriction.
(except that such prohibition shall not be construed as prohibiting payment under the preceding provisions of this section for costs attributable to the establishment or operation of a system designed to ensure compliance with such prohibition)
Section 3 would require the Department of Health and Human Services Inspector General to report to Congress within 180 days after enactment. The report would concern states providing health benefits to noncitizens who are not lawful permanent residents and are ineligible for Medicaid because of immigration status.
Not later than 180 days after the date of enactment of this Act, the Inspector General of the Department of Health and Human Services shall submit to Congress a report that includes the following information with respect to States that provide health benefits to noncitizens who are not lawfully admitted permanent residents and are ineligible on the basis of immigration status for medical assistance under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
The report would explain how affected states separate Medicaid administrative expenses from administrative expenses for health benefits provided to these noncitizens. It would also examine states’ procedures for complying with federal funding prohibitions and how effective those procedures are.
(1) How such States separate amounts expended on the administrative costs related to the State's Medicaid program and amounts expended on administrative costs related to providing health benefits to such noncitizens.
(2) The types of procedures, protocols, or systems that such States employ to ensure that they are in full compliance with prohibitions on the use of Federal funding to provide health benefits to such noncitizens and how effective they are at ensuring compliance.
The report would describe how states finance health programs for these noncitizens. Its scope would include increased use of taxes on health care providers and transfers between governments to finance the nonfederal share of Medicaid expenses for people who are not ineligible on the specified immigration grounds. This is a reporting requirement, not a finding that particular states use these methods.
(3) A description of States' methods of financing State programs that provide health benefits to such noncitizens who are ineligible for medical assistance due to not having a satisfactory immigration status, including through the increased use of provider taxes and intergovernmental transfers to finance the non-Federal share of expenditures under the State Medicaid program for medical assistance provided to individuals who are not so ineligible.
The report would examine how extensively these noncitizens receive covered outpatient drugs purchased under the Medicaid Drug Rebate Program or the federal 340B drug discount program.
(4) An analysis of— (A) the extent to which such noncitizens are provided covered outpatient drugs purchased under— (i) the Medicaid Drug Rebate Program under section 1927 of the Social Security Act (42 U.S.C. 1396r–8); or (ii) the drug discount program under section 340B of the Public Health Service Act (42 U.S.C. 256b);
The report would analyze how providing those drugs to these noncitizens affects the legally defined measure called average manufacturer price, including whether that measure would be lower without such provision. The bill requests an analysis; it does not establish that prices would fall.
(B) the effect that the provision to such noncitizens of covered outpatient drugs purchased under the programs described in subparagraph (A) has on the average manufacturer price (as defined in section 1927(k)(1) of the Social Security Act (42 U.S.C. 1396r–8(k)(1))) of such drugs, including whether the average manufacturer price for such drugs would be lower if no drugs purchased under such programs were provided to such noncitizens.
The supplied official-actions snapshot, updated December 5, 2025, records introduction in the House and referral to the House Committee on Energy and Commerce on February 11, 2025.
Source snapshot updated 2025-12-05T21:56:45Z. 2025-02-11: Referred to the House Committee on Energy and Commerce. 2025-02-11: Introduced in House
A closer look
Reviewed version: Introduced in House · 2025-02-11. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version; the bundle does not establish earmark status in other versions or accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow preferential benefit warranting a finding was identified in the complete supplied introduced text. Routine compliance administration does not by itself qualify. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Dec 5, 2025. How PlainBill uses AI