[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 523 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                 S. 523

   To amend title XIX of the Social Security Act to prohibit Federal 
   Medicaid funding for the administrative costs of providing health 
        benefits to individuals who are unauthorized immigrants.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 11, 2025

   Mr. Cassidy (for himself, Mr. Barrasso, Mr. Wicker, and Mrs. Hyde-
Smith) introduced the following bill; which was read twice and referred 
                      to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX of the Social Security Act to prohibit Federal 
   Medicaid funding for the administrative costs of providing health 
        benefits to individuals who are unauthorized immigrants.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Protect Medicaid Act''.

SEC. 2. 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--
            (1) in paragraph (26), by striking ``; or'' and inserting a 
        semicolon;
            (2) in paragraph (27), by striking the period at the end 
        and inserting ``; or''; and
            (3) by inserting after paragraph (27) the following new 
        paragraph:
            ``(28) with respect to any amounts expended for the 
        administration of a State program that provides health benefits 
        to noncitizens who 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).''.

SEC. 3. INSPECTOR GENERAL REPORT.

    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 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.):
            (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.
            (3) A description of States' methods of financing State 
        programs that provide health benefits to 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.
            (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); and
                    (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.
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