Citizenship and immigration rules (changed October 1, 2026)

To get full Medicaid you have to be a U.S. citizen or meet immigration rules. A 2025 federal law, Public Law 119-21, narrowed those rules. Starting October 1, 2026, CMS says full Medicaid and CHIP are limited to:

• U.S. citizens and U.S. nationals
• Lawful permanent residents (green card holders)
• Cuban and Haitian entrants
• People from the Compact of Free Association countries (the Federated States of Micronesia, the Marshall Islands and Palau) living in the U.S.

Groups such as refugees and people granted asylum were covered before but aren't on this list unless they've since become green card holders. If your coverage could be affected, your state should send you a notice. Read it and ask your agency what it means for your family.

The five-year wait

Many green card holders have to wait five years from the date they got their green card before they can get full Medicaid. There are exceptions, and some states cover children and pregnant women who are lawfully residing in the U.S. without the wait. Your state agency can tell you which rules it uses.

Emergency Medicaid

Emergency Medicaid pays for treatment of an emergency medical condition, including labor and delivery, for people who meet every other Medicaid rule except immigration status. The 2025 law didn't change it. Hospitals can help you apply after an emergency.

Mixed-status families

Family members who qualify can get Medicaid even if someone else in the household doesn't. A parent who isn't eligible can apply for their children without applying for themselves, and the application only asks about immigration status for the people who want coverage. You'll still be asked about everyone's income, because it affects the household's eligibility.

Sources: Medicaid and CHIP eligibility for noncitizens (SHO #26-001), CMS; Medicaid & CHIP coverage, HealthCare.gov.