16 Jun New State Laws Impact How Medicaid Collects and Reports Immigration Information
June 16, 2026 ~ Since H.R. 1 (the One Big Beautiful Bill Act) was signed into law in July 2025, five states have passed new laws about how they collect and report citizenship and immigration information from people applying for Medicaid.
Many of these changes are related to new federal Medicaid eligibility rules that take effect on October 1, 2026. Under those rules, Medicaid eligibility will be limited to certain immigration statuses, including:
- U.S. Citizens
- Lawful Permanent Residents (green card holders)
- Certain Cuban and Haitian entrants
- People living in the United States under the Compacts of Free Association (COFA) – citizens of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau
- Certain lawfully present pregnant individuals and children, in states that choose to cover them
The new state laws generally address two issues:
- How states will verify an applicant's citizenship or immigration status.
- When information may be shared with other agencies if a person's immigration status cannot be verified.
State Changes to Medicaid Rules
Beginning August 1, 2026, Medicaid applicants in Louisiana will have one opportunity to provide documents that verify their citizenship or immigration status. Federal rules currently allow up to 90 days to provide this information, while receiving temporary Medicaid coverage. Under the new Louisiana law, if a person's status cannot be verified during that period, they may not receive another opportunity to verify it later.
A previous Louisiana law already in effect requires certain applicant information to be reported to the U.S. Immigration and Customs Enforcement (ICE) if immigration status cannot be verified.
Beginning October 1, 2026, Indiana will require information about Medicaid applicants whose immigration status cannot be verified to be reported to the U.S. Department of Homeland Security (which houses ICE) or other appropriate federal authorities.
Indiana allows hospitals and other qualified entities to make presumptive eligibility determinations, and this new law requires them to provide immigration status information with the application.
Beginning October 1, 2026, North Carolina will require information about Medicaid applicants whose immigration status cannot be verified to be reported to the U.S. Department of Homeland Security or other appropriate federal authorities.
Beginning July 1, 2026, Tennessee will require that applicants for Medicaid and other public benefits who are deemed ineligible based on their immigration status be reported to the state’s Centralized Immigration Enforcement Division. Applicants who willfully provide false information about their citizenship or immigration status must also be reported to the U.S. Attorney’s office for criminal prosecution.
State employees or officials who don’t comply with the reporting requirements may be criminally prosecuted. Ineligible individuals who receive benefits, or those who help someone receive benefits they are not entitled to, are subject to civil penalties.
Beginning January 1, 2027, Medicaid applicants in Wyoming will have one opportunity to provide documents that verify their citizenship or immigration status. Federal rules currently allow up to 90 days to provide this information, while receiving temporary Medicaid coverage. Under the new Wyoming law, if a person's status cannot be verified during that period, they may not receive another opportunity to verify it later.
The new law will require information about Medicaid applicants who are determined to be unlawfully present in the United States to be reported to the U.S. Department of Homeland Security or other appropriate law enforcement authorities. The information of any member of the applicant’s household discovered be unlawfully present in the U.S. must also be reported, even if they did not apply.
Wyoming allows hospitals and other qualified entities to make presumptive eligibility determinations, and this new law requires them provide immigration status information with the application.
In addition, beginning April 1, 2027, Wyoming will join Florida and Texas in requiring hospitals that accept Medicaid to request information about a patient's immigration status when they are admitted. Patients do not have to answer questions about their immigration status, and their answers cannot affect treatment decisions.
What Does This Mean for Medicaid Applicants?
Starting October 1, 2026, states will only be able to provide Medicaid benefits to those qualify under one of H.R. 1’s eligible immigration statuses. This means that applicants will have to provide documentation that verifies they are a U.S. citizen or a qualifying immigrant.
However, as states begin implementing new laws and rules about the collection and sharing of immigration information related to Medicaid, certain federal protections will continue to apply.
State Medicaid agencies may collect identifying information about the other members of an applicant’s household to determine whether they meet financial eligibility requirements, but they may not require information about the citizenship or immigration status of anyone but the applicant.
Federal privacy laws, including the Social Security Act, the Privacy Act of 1974, and the Health Insurance Portability and Accountability Act (HIPAA) may impact how states will implement new requirements to collect and share information about the immigration status of Medicaid applicants.
In states where hospitals are required to ask patients about their immigration status at admission, they are also required to inform the patient that their answer will not affect their ability to receive medical care.
Ask for Help and Stay Informed
Immigration and public benefits rules can be complicated, especially when they overlap.
People with questions about their specific situation may want to seek advice before applying or renewing coverage. Sources of individual advice about Medicaid eligibility include:
- Legal aid organizations, which provide free civil legal services, including help with public benefits, such as Medicaid
- Aging and Disability Resource Centers (ADRCs), which provide benefits counseling to help applicants navigate and apply for Medicaid and other public benefits
You can also stay up-to-date on new laws and rules related to Medicaid by subscribing to our blog.
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