MedicaidCoverageHigh impact
MMP 26-34: H.R.1 Legislation - Section 71109 Alien Medicaid Eligibility Changes
Michigan Medicaid - MDHHS·MI·Enrollment
Effective date
Oct 1, 2026
We identified it
Sep 2, 2026
Summary
Effective October 1, 2026, Section 71109 of H.R.1 restricts Medicaid and CHIP coverage based on immigration status. Only legal permanent residents, Cuban and Haitian entrants, and COFA migrants qualify for full coverage; all other immigration statuses are limited to emergency services only (ESO) coverage regardless of residency duration. Exception: Michigan's CHIPRA election for pregnant individuals and children under 21 remains unaffected.
Action Required
By September 30, 2026: Billing team must update eligibility verification systems and enrollment workflows to screen for immigration status and apply new coverage restrictions. (1) Implement system logic to identify patients with eligible statuses (legal permanent residents, Cuban/Haitian entrants, COFA migrants) versus restricted statuses. (2) Configure billing software to automatically route restricted-status patients to ESO coverage coding only. (3) Update front desk intake forms to capture immigration status if not already documented. (4) Brief patient registration staff on new restrictions and direct them to reference bulletin MMP 24-20 for pregnant individuals and children under 21 exceptions. (5) Audit existing patient records to reclassify coverage for those with non-eligible statuses effective October 1, 2026. (6) Ensure claims are submitted with correct coverage level codes for each patient; claims submitted with incorrect coverage type will be denied. NOTE: Implementation is contingent on CMS State Plan Amendment approval; verify approval status before full implementation.