,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bfdf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #bg1 #bjbc,mr4   
,book] 7= himself1 ,mr4 ,m>key1 ,ms4    
,hirono1 ,mr4 ,blum5?al1 ,mrs4          
,gillibr&1 ,mr4 ,s&]s1 ,ms4 ,w>r51 ,mr4 
,padilla1 ,mrs4 ,murray1 & ,mr4 ,he9ri*7
 introduc$ ! foll[+ bill2 :i* 0 read    
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to exp& access to  
heal? c>e s]vices = immigrants by remov+
 legal & policy b>ri]s to heal?         
insurance cov]age1 & = o!r purposes4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,heal? ,equity & ,access "u ! ,law =  
,immigrant ,families ,act ( #bjbc or !  
,,heal = ,immigrant ,families ,act (    
#bjbc4  #b4 ,f9d+s2 purpose  7a7 ,f9d+s 
,congress f9ds z foll[s3 7#a7 ,heal?    
insurance cov]age r$uces h>mful racial1 
economic1 g5d]1 & heal? inequities by   
alleviat+ co/ b>ri]s to1 & increas+     
utilization (1 necess>y heal? c>e       
s]vices1 especially among l[-income &   
und]s]v$ populations4  7#b7 ,bas$ solely

 on _! immigration /atus1 _m immigrants 
& _! families face legal & policy       
re/rictions on _! ability to obta9      
af=dable heal? insurance cov]age ?r\gh  
,m$icaid1 ! ,*ildr5's ,heal? ,insurance 
,program 7,,*ip71 & ! heal? insurance   
ex*anges4  7#c7 ,lack ( heal? insurance 
cov]age contributes to p]si/5t          
inequities 9 ! prev5tion1 diagnosis1 &  
treatm5t ( heal? conditions4 ,?is leads 
to negative heal? outcomes = immigrants 
& _! families1 especially ,black1       
,indig5\s1 ,lat9x1 ,asian1 ,pacific     
,isl&]1 & o!r ,immigrants ( ,color4     
7#d7 ,black immigrant wom5 (t5 cite co/ 
z a major b>ri] to heal? c>e4 ,_m :o are
 undocum5t$ =go doctor visits altoge!r  
due to ! f9ancial burd5 9 addition to   
consi/5t racial bias by m$ical          
practition]s & racism 9 heal? c>e4  7#e7
 ,ne>ly half ( immigrant wom5 are (     
reproductive age4 ,immigrant wom51      
lesbian1 gay1 bisexual1 transg5d]1 &    
que] 7,,lgbtq7 immigrants1 & immigrants 
) disabilities disproportionately live 9

 h\seholds ) l[ incomes & lack heal?    
insurance cov]age4 ,legal & policy      
b>ri]s to af=dable heal? insurance      
cov]age significantly exac]bate _! risk 
( negative pregnancy-relat$ & o!r       
reproductive & sexual heal? outcomes1 ) 
la/+ heal? & economic consequ5ces =     
immigrant wom51 ,,lgbtq immigrants1     
immigrants ) disabilities1 & _! families
 & society z a :ole4  7#f7 ,d5y+ heal?  
insurance cov]age or impos+ wait+ p]iods
 = heal? insurance cov]age on ! basis ( 
immigration /atus unfairly h9d]s        
immigrants' ability to rea* & ma9ta9 _! 
optimal levels ( heal? & und]m9es !     
economic well-be+ ( _! families4  7#g7  
,l ! ,hyde am5dm5t's prohibition on     
public insurance cov]age = abortion c>e1
 immigration-relat$ heal? c>e           
eligibility b>ri]s h long curtail$      
access to abortion4 ,9 ,june #bjbb1 9   
,dobbs v4 ,jackson ,wom5's ,heal?       
,organization1 ! ,supreme ,c\rt ( !     
,unit$ ,/ates ov]turn$ ! con/itutional  
"r to abortion1 exac]bat+ pre-exi/+     

b>ri]s4 ,9 ! ye> s9ce ! ,dobbs decision 
0 issu$1 #ai ,/ates h bann$ or re/rict$ 
abortion--disproportionately impact+ #ae
 million wom5 ( color & millions (      
transg5d] & nonb9>y p4 ,notably1 9      
#bjbb1 #ci p]c5t ( all ,lat9as liv+ 9   
,/ates t 7 likely to ban abortion foll[+
 ! ,dobbs decision 7 born outside ( !   
,unit$ ,/ates--?is gr\p includes p )    
v>y+ citiz5%ip /atuses1 among :om fe> ( 
surveillance may be p>ticul>ly preval5t1
 due to disproportionate inve/igation & 
surveillance t _m immigrant communities 
already face4 ,bans & re/rictions on    
abortion exac]bate ! fe> (              
crim9alization 9 immigrant communities1 
& contribute to a *ill+ effect t leads  
_m immigrants to =ego reproductive heal?
 c>e & cov]age ( any k9d z !y navigate  
^! int]sect+ risks ( crim9alization4    
,poll+ conduct$ 9 #bjah f\nd "o 9 f\r   
,lat9a_/o vot]s 7#bd p]c5t7 _h a close  
family memb] or fri5d delay or avoid    
heal? c>e because ( fe> relat$ to       
discrim9atory immigration policies1 & "o

 9 five 7#ai p]c5t7 said ! same ab\t    
reproductive heal? c>e4  7#h7 ,ensur+   
access to crucial cov]age ( reproductive
 & sexual heal? s]vices su* z           
contraception & pregnancy-relat$ c>e    
?r\gh ,m$icaid & ! ,af=dable ,c>e ,act  
is imp]ative1 ) only half 7#eb p]c5t7 ( 
immigrants at risk ( un9t5d$ pregnancy  
receiv+ contraceptive c>e 9 ! previ\s   
ye>4 ,_m immigrants are be+ d5i$ ! basic
 human "r to make ! heal? c>e decisions 
!y believe are be/ = !m & _! families1  
includ+ abortion c>e1 simply because (  
_! immigration /atus4 ,9 ,/ates along ! 
,s\!rn ,bord]1 immigrant communities are
 subject to int]ior *eckpo9ts t increase
 ! ?reat ( family sep>ation1            
deportation1 & det5tion1 & comp\nd ! h>m
 ( abortion re/rictions t =ce p to      
travel to obta9 c>e4 ,immigrants liv+   
)\t docum5tation1 9 p>ticul>1 may h no  
way ( obta9+ an abortion :5 immigration 
en=cem5t & abortion re/rictions comb9e  
to prev5t !m f travel+ to a provid]4    
,fur!r1 due to ! high co/ ( travel      

associat$ ) ! onslaught ( abortion bans1
 practical support organizations t assi/
 ) proc$ure & travel co/s h be5 exp]i5c+
 high dem&1 & /ruggle ) inadequate      
res\rces4 ,access+ support s]vices c be 
out ( rea* = ^? )\t reliable te*nology  
to rese>* & ma9ta9 contact ) support    
s]vices1 or :o enc\nt] l+ui/ic b>ri]s :5
 support s]vices are n able to provide  
translators4 ,= _m1 abortion c>e w be   
entirely inaccessible due to ^! comp\nd+
 b>ri]s1 ?us exac]bat+ ! ne$ =          
accessible reproductive & sexual heal?  
s]vices su* z contraception &           
pregnancy-relat$ & po/-pregnancy c>e4   
7#i7 ,int]national human rights /&>ds   
hold t gov]nm5ts h an affirmative       
obligation to ensure t ev]yone1 includ+ 
immigrants1 c access safe1 respectful1  
culturally & l+ui/ically appropriate1 & 
high-quality pregnancy-relat$ c>e1      
includ+ po/p>tum c>e1 free f            
discrim9ation or viol5ce4 ,m$icaid is ! 
nation's s+le l>ge/ pay] =              
pregnancy-relat$ c>e4 ,nev]!less1 b>ri]s

 to heal? cov]age p]si/ = pregnant &    
po/p>tum p1 p>ticul>ly immigrants4      
7#aj7 ,immigrants--especially ,black1   
,indig5\s1 ,lat9x1 ,asian1 & ,pacific   
,isl&] immigrants--are among ^? mo/ h>m$
 by ! ,unit$ ,/ates pregnancy-relat$    
morbidity & mortality epidemic1 :i* is !
 wor/ among high-income nations4 ,black 
p are ne>ly f\r times m likely ?an :ite 
p to suff] pregnancy-relat$ dea?1 &     
twice z likely to suff] mat]nal         
morbidity4 ,indig5\s p are two & a half 
times m likely ?an :ite p to die f a    
pregnancy-relat$ dea?4 ,! majority (    
,unit$ ,/ates pregnancy-relat$ dea?s are
 prev5table4 ,lack ( access to heal?    
c>e1 immigration /atus1 pov]ty1 &       
exposure to racism1 sexism1 & x5ophobia 
9 & beyond ! heal? c>e sy/em contribute 
to ! disproportionately high numb] (    
pregnancy-relat$ dea?s among ,,bipoc    
bir?+ & po/p>tum p4 ,unnecess>y b>ri]s t
 limit pregnant & po/p>tum immigrants'  
access to heal? c>e und]m9e _! heal?1   
safety1 & human rights4  7#aa7 ,"o 9    

sev5 ,unit$ ,/ates resid5ts is          
=eign-born1 approximately "o 9 f\r      
*ildr5 9 ! ,unit$ ,/ates has at lea/ "o 
immigrant p>5t1 & ! population (        
immigrant families 9 ! ,unit$ ,/ates is 
expect$ to cont9ue to gr[ 9 ! com+ ye>s4
 ,x is !re=e 9 our collective public    
heal? & economic int]e/ to remove legal 
& policy b>ri]s to af=dable heal?       
insurance cov]age t are bas$ on         
immigration /atus4  7#ab7 ,delay+ or    
d5y+ heal? insurance cov]age because (  
immigration /atus c imp$e m5tal heal? & 
sub/ance use prev5tion & e>ly int]v5tion
 int]v5tions4 ,n ackn[l$g+ ! impacts (  
trauma c impact m5tal heal? & sub/ance  
use1 & conditions may increase 9 sev]ity
 )\t appropriate & consi/5t support &   
treatm5t4  7#ac7 ,al?\gh individuals    
grant$ relief "u ! ,def]r$ ,action =    
,*ildhood ,arrivals 7,,daca7 program are
 au?oriz$ to live & "w 9 ! ,unit$       
,/ates1 !y h be5 unfairly exclud$ f !   
def9itions ( lawfully pres5t & lawfully 
resid+ = purposes ( heal? insurance     

cov]age provid$ ?r\gh ! ,dep>tm5t (     
,heal? & ,human ,s]vices1 includ+       
,m$icaid1 ,,*ip1 & ! heal? insurance    
ex*anges4  7#ad7 ,on ,april #bf1 #bjbc1 
! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices   
7,,cms7 publi%$ a propos$ rule t w\ld   
modify ! def9ition ( lawfully pres5t us$
 to det]m9e eligibility = ,pati5t       
,protection & ,af=dable ,c>e ,act       
7,,aca7 heal? plans & c]ta9 o!r heal?   
c>e programs4 ,codify+ ^! protections 9 
legislation is crucial to ensure        
individuals grant$ relief "u ! ,def]r$  
,action = ,*ildhood ,arrivals 7,,daca7  
program & ^? :o ga9 new =ms (           
adm9i/rative relief are n simil>ly      
exclud$ 9 future adm9i/rative action4   
,?is is ev5 m imp]ative z m ?an a qu>t] 
( ,,daca recipi5ts are curr5tly un9sur$ 
z !y await ! f9alization ( ! propos$    
rule4  7#ae7 ,s9ce immigration law      
evolves con/antly1 new immigration      
categories = individuals ) f$]ally      
au?oriz$ pres5ce 9 ! ,unit$ ,/ates may  
be creat$4  7#af7 ,"s ,/ates cont9ue to 

unwisely re/rict ,m$icaid access =      
immigrants :o h long resid$ 9 ! ,unit$  
,/ates1 fuel+ significant heal?         
inequities & increas+ heal? c>e co/s =  
individuals & ! public4  7#ag7 ,congress
 re/or$ ,m$icaid eligibility =          
individuals liv+ 9 ! ,unit$ ,/ates "u ! 
,compacts ( ,free ,association z "p (   
bip>tisan legislation 9 ,decemb] #bjbj &
 %\ld build on t success by ensur+ all  
immigrants c access c>e4  7b7 ,purpose  
,x is ! purpose ( ?is ,act to-- 7#a7    
ensure t all individuals :o are lawfully
 pres5t 9 ! ,unit$ ,/ates are eligible =
 all f$]ally fund$ heal? c>e programs2  
7#b7 advance ! ability ( undocum5t$     
individuals to obta9 heal? insurance    
cov]age ?r\gh ! heal? insurance ex*anges
 e/abli%$ "u "p ,,ii ( ! ,pati5t        
,protection & ,af=dable ,c>e ,act1      
,public ,law #aaa-adh2  7#c7 elim9ate ! 
au?ority = ,/ates to re/rict ,m$icaid   
eligibility = lawful p]man5t resid5ts2 &
  7#d7 elim9ate o!r b>ri]s to access+   
,m$icaid1 ,,*ip1 & o!r m$ical assi/ance4

  #c4 ,remov+ b>ri]s to heal? cov]age = 
lawfully resid+ individuals  7a7        
,m$icaid ,section #aijc7v77#d7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7v77#d77 is am5d$-- 7#a7 by am5d+
 subp>agraph 7,a7 to read z foll[s3     
7,a7 ,not)/&+ sections #dja7;a71        
#djb7;b71 #djc1 & #dba ( ! ,p]sonal     
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif1 a ,/ate   
%all provide m$ical assi/ance "u ?is    
title1 to individuals :o are lawfully   
resid+ 9 ! ,unit$ ,/ates 7includ+       
individuals describ$ 9 p>agraph 7#a71   
batt]$ individuals describ$ 9 section   
#dca7;c7 ( su* ,act1 & individuals ) an 
approv$ or p5d+ application = def]r$    
action or o!r f$]ally au?oriz$ pres5ce71
 if !y o!rwise meet ! eligibility       
requirem5ts = m$ical assi/ance "u !     
,/ate plan approv$ "u ?is title 7o!r ?an
 ! requirem5t ( ! receipt ( aid or      
assi/ance "u title ,,iv1 supplem5tal    
security income b5efits "u title ,,xvi1 
or a ,/ate supplem5t>y paym5t74  2  7#b7

 by am5d+ subp>agraph 7,b7 to read z    
foll[s3  7,b7 ,no debt %all accrue "u an
 affidavit ( support aga9/ any sponsor (
 an individual provid$ m$ical assi/ance 
"u subp>agraph 7,a7 on ! basis (        
provision ( assi/ance to su* individual 
& ! co/ ( su* assi/ance %all n be       
consid]$ z an unreimburs$ co/4  2 &     
7#c7 9 subp>agraph 7,c7-- 7,a7 by /rik+ 
an election by ! ,/ate "u subp>agraph   
7,a7 & ins]t+ ! application (           
subp>agraph 7,a72  7,b7 by ins]t+ or be 
lawfully pres5t aft] lawfully reside2 & 
7,c7 by ins]t+ or pres5t aft] lawfully  
resid+ ea* place x appe>s4  7b7 ,,*ip   
,subp>agraph 7,n7 ( section             
#bajg7;e77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;gg7e77#a77 is     
am5d$ to read z foll[s3  7,n7 ,p>agraph 
7#d7 ( section #aijc7v7 7relat+ to      
lawfully pres5t individuals & undocum5t$
 immigrants74  4  7c7 ,effective date   
7#a7 ,9 g5]al ,except z provid$ 9       
p>agraph 7#b71 ! am5dm5ts made by ?is   
section %all take effect on ! date (    

enactm5t ( ?is ,act & %all apply to     
s]vices furni%$ on or aft] ! date t is  
#ij days aft] su* date ( enactm5t4  7#b7
 ,exception if ,/ate legislation requir$
 ,9 ! case ( a ,/ate plan = m$ical      
assi/ance "u title ,,xix1 or a ,/ate    
*ild heal? plan "u title ,,xxi1 ( !     
,social ,security ,act :i* ! ,secret>y (
 ,heal? & ,human ,s]vices det]m9es      
requires ,/ate legislation 7o!r ?an     
legislation appropriat+ funds7 9 ord] = 
! plan to meet ! additional requirem5ts 
impos$ by ! am5dm5ts made by ?is        
section1 ! respective ,/ate plan %all n 
be reg>d$ z fail+ to comply ) !         
requirem5ts ( su* title solely on !     
basis ( its failure to meet ^!          
additional requirem5ts be=e ! fir/ day (
 ! fir/ cal5d> qu>t] beg9n+ aft] ! close
 ( ! fir/ regul> session ( ! ,/ate      
legislature t beg9s aft] ! date (       
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      

sep>ate regul> session ( ! ,/ate        
legislature4  #d4 ,consi/5cy 9 heal?    
insurance cov]age = individuals )       
f$]ally au?oriz$ pres5ce1 includ+ def]r$
 action  7a7 ,9 g5]al ,= purposes (     
eligibility "u any ( ! provisions       
describ$ 9 subsection 7b71 all          
individuals grant$ f$]ally au?oriz$     
pres5ce 9 ! ,unit$ ,/ates %all be       
consid]$ to be lawfully pres5t 9 !      
,unit$ ,/ates4  7b7 ,provisions describ$
 ,! provisions describ$ 9 ?is subsection
 are ! foll[+3 7#a7 ,ex*ange eligibility
 ,section #adaa ( ! ,pati5t ,protection 
& ,af=dable ,c>e ,act 7#db ,u4,s4,c4    
#ahjca74  7#b7 ,r$uc$ co/-%>+           
eligibility ,section #adjb ( ! ,pati5t  
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjga74  7#c7 ,premium       
subsidy eligibility ,section #cf;,b ( ! 
,int]nal ,rev5ue ,code ( #aihf 7#bf     
,u4,s4,c4 #cf;,b74  7#d7 ,m$icaid & *ip 
eligibility ,titles ,,xix & ,,xxi ( !   
,social ,security ,act1 includ+ "u      
section #aijc7v7 ( su* ,act 7#db        

,u4,s4,c4 #acif;b7v774  7c7 ,effective  
date  7#a7 ,9 g5]al ,subsection 7a7 %all
 take effect on ! date ( enactm5t ( ?is 
,act4  7#b7 ,transition ?r\gh special   
enrollm5t p]iod ,9 ! case ( an          
individual describ$ 9 subsection 7a7 :o1
 be=e ! fir/ day ( ! fir/ annual op5    
enrollm5t p]iod "u subp>agraph 7,b7 (   
section #acaa7;c77#f7 ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjca7;c77#f77 beg9n+ aft] ! 
date ( enactm5t ( ?is ,act1 is grant$   
f$]ally au?oriz$ pres5ce 9 ! ,unit$     
,/ates & :o1 z a result ( su*           
subsection1 qualifies = a subsidy "u a  
provision describ$ 9 p>agraph 7#b7 or   
7#c7 ( subsection 7b71 ! ,secret>y (    
,heal? & ,human ,s]vices %all e/abli% a 
special enrollm5t p]iod "u subp>agraph  
7,c7 ( su* section #acaa7;c77#f7 dur+   
:i* su* individual may enroll 9 qualifi$
 heal? plans ?r\gh ,ex*anges "u title ,i
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act & qualify = su* a subsidy4 ,= 
su* an individual :o has be5 grant$     

f$]ally au?oriz$ pres5ce 9 ! ,unit$     
,/ates z ( ! date ( enactm5t ( ?is ,act1
 su* special enrollm5t p]iod %all beg9 n
 lat] ?an #ij days aft] su* date (      
enactm5t4 ,no?+ 9 ?is p>agraph %all be  
con/ru$ z affect+ ! au?ority ( !        
,secret>y to e/abli% additional special 
enrollm5t p]iods "u su* subp>agraph     
7,c74  #e4 ,remov+ citiz5%ip &          
immigration b>ri]s to access to af=dable
 heal? c>e "u ! ,,aca  7a7 ,9 g5]al     
7#a7 ,premium tax cr$its ,section #cf;,b
 ( ! ,int]nal ,rev5ue ,code ( #aihf is  
am5d$-- 7,a7 9 subsection 7c77#a77;,b7--
 7i7 by am5d+ ! head+ to read z foll[s3 
,special rule = c]ta9 individuals       
ineligible = m$icaid due to /atus2 &    
7ii7 by am5d+ clause 7ii7 to read z     
foll[s3  7ii7 ! taxpay] is a noncitiz5  
:o is n eligible = ! ,m$icaid program "u
 title ,,xix ( ! ,social ,security ,act 
by reason ( ! individual's immigration  
/atus1  2 &  7,b7 by /rik+ subsection   
7e74  7#b7 ,co/-%>+ r$uctions ,section  
#adjb ( ! ,pati5t ,protection &         

,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjga7 is am5d$ by /rik+ subsection 7e7
 & r$esignat+ subsection 7f7 z          
subsection 7e74  7#c7 ,basic heal?      
program eligibility ,section            
#acca7;e77#a77;,b7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjea7;e77#a77;,b77 is am5d$ 
by /rik+ lawfully pres5t 9 ! ,unit$     
,/ates14  7#d7 ,re/rictions on f$]al    
paym5ts ,section #adab ( ! ,pati5t      
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjhb7 is am5d$ by /rik+     
subsection 7d7 & r$esignat+ subsection  
7e7 z subsection 7d74  7#e7 ,requirem5t 
to ma9ta9 m9imum ess5tial cov]age       
,subsection 7d7 ( section #ejjj;,a ( !  
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ p>agraph 7#c7 & by r$esignat+  
p>agraph 7#d7 z p>agraph 7#c74  7b7     
,con=m+ am5dm5ts  7#a7 ,e/abli%m5t (    
program ,section #adaa7;a7 ( ! ,pati5t  
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjha7;a77 is am5d$ by /rik+ 
p>agraph 7#a7 & r$esignat+ p>agraphs    

7#b71 7#c71 & 7#d7 z p>agraphs 7#a71    
7#b71 & 7#c71 respectively4  7#b7       
,qualifi$ individuals ,section #acab7;f7
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act 7#db ,u4,s4,c4 #ahjcb7;f77 is 
am5d$-- 7,a7 9 ! head+1 by /rik+ 2      
access limit$ to citiz5s & lawful       
resid5ts2 &  7,b7 by /rik+ p>agraph     
7#c74  7c7 ,effective date ,! am5dm5ts  
made by ?is section %all apply to ye>s1 
plan ye>s1 & taxable ye>s1 z applicable1
 beg9n+ aft] ,decemb] #ca1 #bjbc4  #f4  
,/ate option to exp& ,m$icaid & ,,*ip to
 individuals )\t lawful pres5ce  7a7    
,m$icaid  7#a7 ,9 g5]al ,section        
#aijb7;a77#aj77;,a77ii7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#aj77;,a77ii77 is am5d$--    
7,a7 9 subclause 7,,xxii71 by /rik+ or  
at ! end2  7,b7 9 subclause 7,,xxiii71  
by /rik+ ! semicolon & ins]t+ 2 or2 &   
7,c7 by add+ at ! end ! foll[+ new      
subclause3  7,,xxiv7 :o w\ld be eligible
 "u ! ,/ate plan 7or waiv] ( su* plan7  
"u ?is title if !y 7 citiz5s ( ! ,unit$ 

,/ates2  4  7#b7 ,con=m+ am5dm5t        
,section #aije7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acif;d7a77 is     
am5d$1 9 ! matt] prec$+ p>agraph 7#a7-- 
7,a7 9 ! matt] designat$ z clause       
7xxvi71 by /rik+ or at ! end2  7,b7 9 ! 
matt] designat$ z clause 7xxvii71 by    
add+ or at ! end2 &  7,c7 by ins]t+ aft]
 ! matt] designat$ z clause 7xxvii7 !   
foll[+3  7xxviii7 individuals describ$ 9
 section                                
#aijb7;a77#aj77;,a77ii77,,xxiv71  4  7b7
 ,,*ip ,title ,,xxi ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acig;aa  
et seq47 is am5d$ by ins]t+ aft] section
 #baab ! foll[+ new section3  #baab;,a4 
,/ate option to provide cov]age =       
individuals )\t lawful pres5ce ,a ,/ate 
may elect ?r\gh an am5dm5t to its ,/ate 
*ild heal? plan "u section #bajb to     
treat an individual z a t>get$ l[-income
 *ild or a t>get$ l[-income pregnant    
woman = purposes ( ?is title if su*     
individual w\ld o!rwise be includ$ z su*
 a *ild or su* a pregnant woman 7z      

applicable7 "u su* plan if ! individual 
7 a citiz5 ( ! ,unit$ ,/ates4  4  7c7   
,nonapplication ( eligibility           
prohibition ,section #dja7;a7 ( !       
,p]sonal ,responsibility & ,"w          
,opportunity ,reconciliation ,act (     
#aiif 7#db ,u4,s4,c4 #afaa7;a77 is am5d$
 by add+ at ! end ! foll[+ new s5t5ce3  
,! prec$+ s5t5ce %all n apply ) respect 
to a noncitiz5's eligibility "u a ,/ate 
plan 7or waiv] ( su* plan7 "u title     
,,xix ( ! ,social ,security ,act or "u a
 ,/ate *ild heal? plan 7or waiv] ( su*  
plan7 "u title ,,xxi ( su* ,act to !    
ext5t t su* ,/ate has elect$ to make su*
 individual s eligible pursuant to      
section #aijb7;a77#aj77;,a77ii77,,xxiv7 
or #baab;,a ( su* ,act1 respectively44  
#g4 ,pres]v+ access to cov]age  7a7 ,9  
g5]al ,no?+ 9 ?is ,act1 includ+ !       
am5dm5ts made by ?is ,act1 %all prev5t  
lawfully pres5t noncitiz5s :o are       
ineligible = full b5efits "u ! ,m$icaid 
program "u title ,,xix ( ! ,social      
,security ,act f secur+ a cr$it = :i*   

su* lawfully pres5t noncitiz5s w\ld be  
eligible "u section #cf;,b7c77#a77;,b7 (
 ! ,int]nal ,rev5ue ,code ( #aihf & "u !
 ,m$icaid provisions = lawfully pres5t  
noncitiz5s1 z 9 effect on ! date prior  
to ! date ( enactm5t ( ?is ,act4  7b7   
,def9ition ,= purposes ( subsection 7a71
 ! t]m full b5efits means1 ) respect to 
an individual & ,/ate1 m$ical assi/ance 
= all s]vices cov]$ "u ! ,/ate plan "u  
title ,,xix ( ! ,social ,security ,act t
 is n less 9 am\nt1 duration1 or scope1 
or is det]m9$ by ! ,secret>y ( ,heal? & 
,human ,s]vices to be sub/antially      
equival5t to ! m$ical assi/ance         
available = an individual describ$ 9    
section #aijb7;a77#aj77;,a77i7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#aj77;,a77i774  #h4 ,remov+  
b>ri]s to heal? cov]age = lawfully      
pres5t individuals 9 ,m$ic>e  7a7 ,"p ,a
 ,section #ahah7;a77#c7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acie;i-#b7;a77#c77 is am5d$ by /rik+ an
 ali5 & all t foll[s ?r\gh "u ?is       

section & ins]t+ an individual :o is    
lawfully pres5t 9 ! ,unit$ ,/ates1      
includ+ individuals ) an approv$ or p5d+
 application = def]r$ action or o!r     
f$]ally au?oriz$ pres5ce4  7b7 ,"p ,b   
,section #ahcf7b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acieo7#b77 is am5d$
 by /rik+ an ali5 & all t foll[s ?r\gh  
"u ?is "p & ins]t+ an individual :o is  
lawfully pres5t 9 ! ,unit$ ,/ates1      
includ+ individuals ) an approv$ or p5d+
 application = def]r$ action or o!r     
f$]ally au?oriz$ pres5ce4  7c7 ,lawfully
 pres5t def9$ ,! t]m lawfully pres5t    
%all include1 at a m9imum1 all          
immigration categories t are treat$ z   
lawfully pres5t = purposes ( ! title    
,,xix program z am5d$ by section #c4