[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 5037 Introduced in Senate (IS)]
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119th CONGRESS
2d Session
S. 5037
To amend title XIX of the Social Security Act to make all children
eligible for Medicaid from birth until age 26, to require States to
automatically enroll children and young adults under age 26 in the
State Medicaid program, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 21, 2026
Mr. Kim (for himself, Ms. Duckworth, Mr. Padilla, and Mr. Booker)
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 make all children
eligible for Medicaid from birth until age 26, to require States to
automatically enroll children and young adults under age 26 in the
State Medicaid program, and for other purposes.
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 ``MediKids Act''.
SEC. 2. MEDIKIDS.
(a) Eligibility Until Age 26.--
(1) In general.--Section 1902(a)(10)(A)(i) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(A)(i)) is amended--
(A) by striking ``or'' at the end of subclause
(VIII);
(B) in subclause (IX)(dd), by inserting ``or'' at
the end; and
(C) by adding at the end the following new
subclause:
``(X) beginning on the date that is
2 years after the date of enactment of
this subclause, who are individuals who
have not attained 26 years of age;''.
(2) Effective date.--The amendment made by this subsection
shall take effect on the date of enactment of this Act.
(b) Automatic Enrollment.--Section 1902(e) of the Social Security
Act is amended by striking paragraph (4) and inserting the following:
``(4) Automatic enrollment of children.--
``(A) In general.--Any child born in a State on or
after the date that is 2 years after the date of
enactment of the MediKids Act shall be considered to
have applied for medical assistance under the State
plan and shall be automatically enrolled for such
assistance on the date of their birth.
``(B) Notification requirement.--The State shall
inform the parent, guardian, or custodial relative of a
child who is automatically enrolled in the State plan
under subparagraph (A) of the services that will be
covered, appropriate methods for using such services,
medical support obligations (under section 1912(a))
created by enrollment (if applicable), the actions the
parent, guardian, or relative must take (if any) to
maintain enrollment, and the actions the parent,
guardian, or relative may take to disenroll the child.
``(C) Opt-out if other coverage is available.--The
State shall establish a process to allow the parent,
guardian, or custodial relative of a child who is
automatically enrolled in the State plan under
subparagraph (A) to disenroll the child from the State
plan through affirmation in writing if the child is
enrolled in other health benefits coverage that--
``(i) at a minimum, provides the essential
health benefits defined by the Secretary under
section 1302(b) of the Patient Protection and
Affordable Care Act; and
``(ii) meets such other requirements as the
Secretary determines appropriate.
``(D) Special rule.--With respect to an individual
who is automatically enrolled in the State plan under
subparagraph (A) as a child and has attained 18 years
of age, the notification requirement described in
subparagraph (B) and the opt-out requirement described
in subparagraph (C) shall apply to such individual in
lieu of the parent, guardian, or custodial relative of
such individual.''.
(c) Continuous Eligibility.--Section 1902(e)(12) of the Social
Security Act (42 U.S.C. 1396a(e)(12)) is amended--
(1) in the heading by inserting ``and young adults'' after
``children'';
(2) in the matter preceding subparagraph (A), by striking
``19'' and inserting ``26'';
(3) by striking subparagraph (A);
(4) by redesignating subparagraphs (B) and (C) as
subparagraphs (A) and (B); and
(5) in subparagraph (A), as so redesignated, by striking
``19'' and inserting ``26''.
(d) Exclusion From Definition of Minimum Essential Coverage.--
Section 36B(c)(2) of the Internal Revenue Code of 1986 is amended by
adding at the end the following new subparagraph:
``(D) Treatment of certain coverage under the
medicaid program.--For purposes of subparagraph (B), an
individual shall not be treated as eligible for minimum
essential coverage if--
``(i) such coverage consists of eligibility
for medical assistance under a State Medicaid
program under section 1902(a)(10)(A)(i)(X) of
the Social Security Act; and
``(ii) the individual is not enrolled in
such a program for such medical assistance.''.
(e) Coverage of Children and Young Adults Without Regard to
Immigration Status.--
(1) In general.--Section 1903(v) of the Social Security Act
(42 U.S.C. 1396b(v)) is amended--
(A) in paragraph (1), by striking ``and (5)'' and
inserting ``(5), and (6)'';
(B) in paragraph (4)(A)(ii)--
(i) in the clause header, by inserting
``and young adults'' after ``Children''; and
(ii) by striking ``21'' and inserting
``26''; and
(C) by adding at the end the following paragraph:
``(6)(A) Notwithstanding any other provision of law, on and after
the date that is 2 years after the date of enactment of this paragraph,
a State shall provide medical assistance under this title to any
individual residing or present in the United States who is eligible for
medical assistance under section 1902(a)(10)(A)(i)(X), without regard
to whether the individual is lawfully residing or lawfully present in
the United States.
``(B) No debt shall accrue under an affidavit of support against
any sponsor of an individual provided medical assistance in accordance
with subparagraph (A) and the cost of such assistance shall not be
considered as an unreimbursed cost.''.
(2) Conforming amendments.--
(A) Section 1137(f) of the Social Security Act (42
U.S.C. 1320b-7(f)) is amended by inserting ``or to
individuals who are eligible for medical assistance
under section 1902(a)(10)(A)(i)(X) and are provided
such assistance in accordance with section 1903(v)(6)''
before the period.
(B) Section 2107(e)(1)(Q) of the Social Security
Act (42 U.S.C. 1397gg(e)(1)(Q)) is amended by inserting
``and young adults'' after ``children'' each place it
appears.
(C) Section 402(b)(2) of the Personal
Responsibility and Work Opportunity Reconciliation Act
of 1996 (8 U.S.C. 1612(b)(2)) is amended by adding at
the end the following:
``(H) Medicaid exception for children and young
adults.--With respect to eligibility for benefits for
the program defined in paragraph (3)(C) (relating to
the Medicaid program), section 401(a) and paragraph (1)
shall not apply to any individual who has not attained
26 years of age.''.
(D) Section 403(d) of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (8
U.S.C. 1613(d)) is amended--
(i) by striking ``or'' at the end of
paragraph (1);
(ii) by striking the period at the end of
paragraph (2) and inserting ``; or''; and
(iii) by adding at the end the following:
``(3) an individual described in section 402(b)(2)(H), but
only with respect to the program specified in subsection
(b)(3)(C) of section 402.''.
(E) Section 431(b) of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (8
U.S.C. 1641(b)) is amended--
(i) by striking ``or'' at the end of
paragraph (7);
(ii) by striking the period at the end of
paragraph (8) and inserting ``, or''; and
(iii) by adding at the end the following:
``(9) an individual who has not attained 26 years of age,
but only with respect to the designated Federal program defined
in section 402(b)(3)(C) (relating to the Medicaid program).''.
(3) Effective date.--The amendments made by this subsection
shall take effect on the date of enactment of this Act.
(f) 100 Percent Federal Matching Payments for Medical Assistance
for Children and Young Adults.--
(1) In general.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(A) in subsection (b), by striking ``and (ii)'' and
inserting ``(ii), and (ll)''; and
(B) by adding at the end the following new
subsection:
``(ll) Enhanced FMAP for Certain Children and Young Adults.--
Notwithstanding subsection (b), beginning on the date that is 2 years
after the date of enactment of this subsection, the Federal medical
assistance percentage shall be 100 percent with respect to amounts
expended by a State for medical assistance for individuals--
``(1) who are eligible for medical assistance under section
1902(a)(10)(A)(i)(X); and
``(2) who would not have been eligible for medical
assistance for full benefits (as defined in subsection
(y)(2)(B)) under the State plan under this title or a waiver of
such plan as such plan or waiver was in effect on January 1,
2025.''.
(2) Effective date.--The amendment made by this subsection
shall take effect on the date of enactment of this Act.
(g) Exclusion From Community Engagement Requirement.--
(1) Mandatory exception for certain individuals.--Section
1902(xx)(3)(A)(i)(II) of the Social Security Act (42 U.S.C.
1396a(xx)(3)(A)(i)(II)) is amended--
(A) in item (aa), by striking ``19'' and inserting
``26''; and
(B) in item (cc), by inserting ``or (X)'' after
``(VII)''.
(2) Specified excluded individuals.--
(A) In general.--Section 1902(xx)(9)(A)(ii)(I) of
the Social Security Act (42 U.S.C.
1396a(xx)(9)(A)(ii)(I)) is amended to read as follows:
``(I) who is described in subclause
(IX) or (X) of subsection
(a)(10)(A)(i);''.
(B) Conforming amendment.--Section
1902(xx)(9)(A)(i)(II)(bb) of the Social Security Act
(42 U.S.C. 1396a(xx)(9)(A)(i)(II)(bb)) is amended by
striking ``19'' and inserting ``26''.
(h) Expansion of EPSDT.--
(1) In general.--Section 1905(a)(4)(B) of the Social
Security Act (42 U.S.C. 1396d(a)(4)(B)) is amended by striking
``21'' and inserting ``26''.
(2) Conforming amendment.--Title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) is amended in section
1902(a)(43)(A), by striking ``21'' and inserting ``26''.
(i) Other Conforming Amendments.--Title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) is amended--
(1) in section 1905(a)--
(A) in the matter preceding paragraph (1)--
(i) in clause (i), by striking ``21, or, at
the option of the State, under the age of 20,
19, or 18 as the State may choose'' and
inserting ``26''; and
(ii) in clause (xiv), by striking ``or
1902(a)(10)(A)(i)(IX)'' and inserting ``,
1902(a)(10)(A)(i)(IX), or
1902(a)(10)(A)(i)(X)''; and
(B) in paragraph (16)(A), by striking ``21'' and
inserting ``26'';
(2) in section 1905(h)(1)--
(A) in the matter preceding subparagraph (A), by
striking ``21'' and inserting ``26''; and
(B) in subparagraph (C)--
(i) by striking ``21'' each place it
appears and inserting ``26''; and
(ii) by striking ``22'' and inserting
``27'';
(3) in section 1915(l)(7)(A)(ii), by striking ``21'' and
inserting ``26'';
(4) in section 1916--
(A) in subsection (a)(2)(A), by striking ``18 years
of age (and, at the option of the State, individuals
under 21, 20, or 19 years of age, or any reasonable
category of individuals 18 years of age or over)'' and
inserting ``26 years of age''; and
(B) in subsection (b)(2)(A), by striking ``18 years
of age (and, at the option of the State, individuals
under 21, 20, or 19 years of age, or any reasonable
category of individuals 18 years of age or over)'' and
inserting ``26 years of age'';
(5) in section 1917--
(A) in subsection (a)(2)(B), by striking ``21'' and
inserting ``26''; and
(B) in subsection (b)(2)(A), by striking ``21'' and
inserting ``26''; and
(6) in section 1937(a)(2)(B), by adding at the end the
following new clause:
``(xii) Medikids.--The individual qualifies
for medical assistance on the basis of section
1902(a)(10)(A)(i)(X).''.
(j) Effective Date.--Except as otherwise provided, the amendments
made by this section shall take effect on the date that is 2 years
after the date of enactment of this Act.
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