Medicaid Coverage for Immigrants by State 2026 (CA, NY, IL, MA, OR, WA)

Quick Answer: Which States Cover Immigrants in 2026?

It depends on immigration status and state. Six states use state-only funds or waivers to go beyond federal Medicaid rules. See state Medicaid expansion status for the full picture: California (Medi-Cal), New York, Illinois, Massachusetts (MassHealth), Oregon (OHP), and Washington (Apple Health). Federal Medicaid requires a five-year waiting period for most lawfully present immigrants. After October 1, 2026, H.R. 1 restricts federal Medicaid to lawful permanent residents, Cuban and Haitian entrants, and COFA migrants only. Emergency Medicaid remains available in all states regardless of immigration status.

Federal Rules That Apply in All States (The Floor)

Federal Medicaid law, as updated by H.R. 1 signed in 2025, sets a strict floor for who can use federal Medicaid dollars. See the complete Medicaid immigrant eligibility rules. Lawful permanent residents (green card holders) must wait five years from the date they received their green card before qualifying for federal Medicaid, with exceptions for refugees, asylees, Cuban and Haitian entrants, COFA migrants (citizens of the Freely Associated States: Marshall Islands, Micronesia, and Palau), and humanitarian parolees. Children and pregnant individuals are exempt from the five-year bar in states that have adopted the CHIP option. Effective October 1, 2026, H.R. 1 narrows the federally eligible immigrant categories further to LPRs post-five-year bar, Cuban and Haitian entrants, and COFA migrants.

Emergency Medicaid is the federal floor for everyone. Undocumented immigrants and lawfully present immigrants who have not met the five-year bar are still eligible for Emergency Medicaid in all 50 states if they meet income requirements and have a qualifying emergency medical condition. Emergency Medicaid covers labor and delivery, serious injuries, acute illness requiring hospitalization, and other urgent conditions. It does not cover routine care, preventive visits, or ongoing prescription drugs.

California: Medi-Cal for Immigrants in 2026

California's Medi-Cal program underwent a significant change on January 1, 2026. Income eligibility is based on Medicaid income limits published by HHS each year. Prior to that date, California had extended full-scope Medi-Cal to all income-eligible adults regardless of immigration status using state-only funds. Beginning January 1, 2026, California froze new enrollments for undocumented adults ages 19 and older. Adults who were already enrolled in Medi-Cal before January 1, 2026 remain covered as long as they stay income-eligible and complete required annual renewals. If a currently enrolled person loses coverage due to a missed renewal, they have a 90-day window to restore it; if coverage lapses beyond that window, the person can only qualify for Emergency Medi-Cal or pregnancy Medi-Cal going forward.

California children and teens under age 19 remain eligible for full-scope Medi-Cal regardless of immigration status. Pregnant individuals are also eligible regardless of immigration status through one year after their pregnancy ends. DACA recipients enrolled before January 1, 2026 retain coverage; new DACA enrollees face the same freeze as other undocumented adults. The California DHCS maintains an immigration-status FAQ at dhcs.ca.gov with the most current rules. The income threshold for Medi-Cal in 2026 is 138% of the Federal Poverty Level: $22,025 per year for one person and $45,540 for a family of four.

New York: Medicaid and the Essential Plan for Immigrants in 2026

New York covers lawfully present immigrants for full Medicaid at incomes at or below 138% of the 2026 Federal Poverty Level ($22,025 per year for a single adult). Refugees, asylees, Cuban and Haitian entrants, and COFA migrants are federally eligible on the same terms as citizens. Lawful permanent residents who have completed the five-year bar are also fully eligible. Undocumented immigrants in New York qualify for Emergency Medicaid for qualifying emergencies, and all income-eligible immigrants who are pregnant qualify for full Medicaid regardless of status.

New York also runs the Essential Plan for lawfully present immigrants with incomes between 138% and 200% FPL, offering comprehensive coverage with no premiums and minimal cost-sharing. A significant change takes effect July 1, 2026: H.R. 1 eliminated the enhanced premium tax credit mechanism that funded the Essential Plan for lawfully present immigrants between 200% and 250% FPL. After July 1, 2026, approximately 450,000 New Yorkers at 200% to 250% FPL lose Essential Plan eligibility. The Essential Plan remains intact for those below 200% FPL ($31,300 per year for a single person in 2026). New York is working to preserve coverage for affected enrollees through its Basic Health Program authority. Apply at NY State of Health: nystateofhealth.ny.gov.

Oregon OHP: Broadest Immigrant Coverage in 2026

Oregon's Oregon Health Plan (OHP) offers the broadest immigrant coverage of any state in 2026. Since July 2023, Oregon has extended full OHP benefits to all income-eligible adults regardless of immigration status, using a combination of state funds and an approved federal 1115 waiver (the Healthier Oregon program). That waiver is approved through September 30, 2027, giving OHP coverage stability through at least the end of 2027. An undocumented adult, a DACA recipient, a TPS holder, or an asylee who lives in Oregon and has household income at or below 138% of the Federal Poverty Level in 2026 ($22,025 per year for one person) qualifies for full OHP benefits: primary care, specialty care, mental health, dental, and vision.

Oregon also clarifies that OHP is not considered a public charge benefit, so applying for OHP does not harm an immigrant's future immigration applications. OHP is not required to report immigration status to federal immigration enforcement agencies. Apply online at OregonHealthCare.gov or by phone at 1-800-699-9075. Oregon Federally Qualified Health Centers (FQHCs) across the state also offer enrollment assistance in multiple languages.

Washington Apple Health, Illinois, and Massachusetts for Immigrants in 2026

Washington's Apple Health covered undocumented adults through a state-funded expansion, but that program closed to new enrollees as of December 2025. Adults already enrolled in Apple Health before that date retain their coverage as long as they stay income-eligible. New undocumented adult applicants in Washington are not eligible for full Apple Health; they qualify for Alien Emergency Medical (AEM) for emergency services. Washington does offer the Cascade Care Savings program, providing a $250 per member per month state subsidy to income-eligible immigrants who are not eligible for federal subsidies, which can be used to purchase a Cascade Care plan on Washington Healthplanfinder. DACA recipients may qualify for state-funded Apple Health for children's coverage or pregnancy care.

Illinois covers lawfully present immigrants with full Medicaid after the five-year bar. Children under 19 and pregnant individuals are exempt from the five-year bar under the AllKids and Illinois state program options. Refugees and asylees historically received full Medicaid in Illinois without a waiting period, but effective October 1, 2026, H.R. 1 removes federally funded coverage for refugees and asylees who do not otherwise meet the newly restricted eligibility categories. Illinois is evaluating state-funded options to bridge that gap, but as of this writing (May 2026) no state-funded replacement has been enacted. Apply through abe.illinois.gov. Massachusetts MassHealth covers lawfully present immigrants for full Medicaid benefits, with COFA migrants treated as qualified aliens eligible from day one. Undocumented immigrants in Massachusetts qualify for the Health Safety Net, a state-funded program covering essential health services at participating providers. MassHealth is not considered a public charge benefit in Massachusetts. Apply at mass.gov/masshealth.

Is Medicaid a Public Charge? (Immigration Consequences)

Medicaid is NOT considered a public charge benefit that could affect your immigration status for most immigrants. Under the 2022 public charge rule (which remains in effect as of May 2026), Medicaid is not included in the public charge determination. The federal government cannot use Medicaid enrollment as a basis to deny a green card or a visa extension. Emergency Medicaid is specifically excluded from public charge in all cases. State-funded programs like Oregon's Healthier Oregon and California's state-funded Medi-Cal for undocumented individuals are also not subject to public charge rules because they are not federal programs.

USCIS does consider Supplemental Security Income (SSI), cash assistance programs like TANF, and long-term institutionalized care under Medicaid in the public charge determination. Those are exceptions. Routine Medicaid for healthcare is not on the list. Immigrants who are worried about public charge should consult a BIA-accredited representative or immigration attorney before making any decisions based on public charge concerns, as the rules can be complex and individual circumstances vary.

What Changes After October 1, 2026 (H.R. 1 Impact)

H.R. 1, signed into federal law in 2025, makes significant changes to immigrant Medicaid eligibility starting October 1, 2026. Federal Medicaid funding will be restricted to three immigrant categories: lawful permanent residents who have completed the five-year bar, Cuban and Haitian entrants, and COFA migrants (citizens of the Freely Associated States). Refugees, asylees, special immigrant visa holders, humanitarian parolees, TPS holders, DACA recipients, and other currently-covered categories lose access to federally funded Medicaid as of that date. States have the option to continue covering those categories using state-only funds, but most states have not yet committed to doing so.

Oregon's 1115 waiver (Healthier Oregon) is separately approved through September 30, 2027 and covers all income-eligible residents regardless of status, meaning OHP is the most insulated from the H.R. 1 October 2026 changes. California, Massachusetts, New York, Illinois, and Washington are each making state-by-state decisions about whether and how to replace federal funding for the affected categories using state funds. The situation will continue to evolve throughout 2026. Advocates recommend that affected immigrants check directly with their state Medicaid agency or a nonprofit health enrollment navigator in the weeks leading up to October 1, 2026.

Can undocumented immigrants get Medicaid in any state?

Full Medicaid using federal funds is not available to undocumented immigrants in any state. However, Oregon (via its Healthier Oregon 1115 waiver, approved through Sept 2027) extends full OHP benefits to all income-eligible adults regardless of status. California (Medi-Cal) covered undocumented adults until Jan 1, 2026, when new enrollments were frozen; those already enrolled remain covered. Emergency Medicaid is available in all 50 states for qualifying emergencies regardless of immigration status.

What is the 5-year bar for Medicaid?

The five-year bar requires most lawfully present immigrants to wait five years from the date of receiving a qualifying immigration status before becoming eligible for federally funded Medicaid. Exceptions include: refugees, asylees, COFA migrants, Cuban and Haitian entrants, and individuals granted humanitarian parole. Under H.R. 1 (effective Oct 1, 2026), the list of immigrant categories federally eligible after the five-year bar is further narrowed to lawful permanent residents, Cuban and Haitian entrants, and COFA migrants.

Does applying for Medicaid hurt my immigration case (public charge)?

No, for most people. Routine Medicaid is not counted in the public charge determination under the 2022 federal rule. Emergency Medicaid is always excluded. State-funded programs like Oregon's Healthier Oregon and California's state-funded Medi-Cal for undocumented individuals are also not federal programs and cannot be used in a public charge analysis. The exception is long-term care under Medicaid for non-emergency institutionalization. If you are concerned, consult a BIA-accredited immigration representative before deciding.

Can DACA recipients get Medicaid?

DACA recipients are not eligible for federally funded Medicaid in most states because DACA is not a qualifying immigration status under federal law. However, Oregon covers DACA recipients through its Healthier Oregon program. California covered DACA recipients as undocumented adults before Jan 1, 2026; those already enrolled retain coverage. Washington's state-funded Apple Health Expansion for undocumented adults (which covered DACA) is closed to new enrollees as of Dec 2025. Illinois and Massachusetts cover DACA recipients only for Emergency Medicaid at the federal level.

What income limit applies for immigrant Medicaid in California, Oregon, and Washington?

All three states use 138% of the 2026 Federal Poverty Level as the income ceiling for their Medicaid-equivalent programs. That equals $22,025 per year ($1,835 per month) for a single person, and $45,540 per year for a family of four in 2026. Income is counted under MAGI rules: gross income minus above-the-line deductions, including the income of all household members for whom you file taxes. SSI, TANF cash assistance, and child support received are not counted.

Are refugees and asylees eligible for Medicaid?

Yes, currently. Refugees and asylees are federally exempt from the five-year bar and are eligible for Medicaid on the same terms as U.S. citizens from the date of their arrival or grant of asylum. However, under H.R. 1 effective October 1, 2026, refugees and asylees will lose federal Medicaid eligibility unless they are also lawful permanent residents, Cuban or Haitian entrants, or COFA migrants. Individual states may continue covering them with state-only funds. Check with your state Medicaid agency after October 1, 2026.

Does Medicaid cover undocumented immigrants for childbirth?

Yes. Pregnant individuals qualify for Medicaid coverage of labor and delivery, prenatal care, and postpartum care in all six states (California, New York, Illinois, Massachusetts, Oregon, Washington) regardless of immigration status, because pregnancy Medicaid is structured as emergency or state-funded coverage. Federal law also allows states to classify unborn children as children for CHIP purposes, which further extends coverage. In all 50 states, Emergency Medicaid covers labor and delivery for any immigrant who meets income requirements.

What is the New York Essential Plan and who qualifies in 2026?

The New York Essential Plan is a low-cost or no-cost health plan for New Yorkers with incomes up to 200% FPL ($31,300/year for a single adult in 2026) who are lawfully present immigrants. It offers comprehensive coverage with no premium for most enrollees and minimal copays. After July 1, 2026, H.R. 1 eliminates federal subsidy eligibility for immigrants at 200%-250% FPL, so the Essential Plan's upper income boundary drops from 250% to 200% FPL. Those already enrolled below 200% FPL retain coverage. Apply at nystateofhealth.ny.gov.