Session Description: In this session, Ted Waters, Phillip Escoriaza, and Jesi Carlson of Feldesman LLP, will explore evolving policy concerns surrounding community health centers’ provision of care to noncitizens. In July 2025, two seismic policy changes in this area shook the health center landscape. First, Congress enacted the One Big Beautiful Bill Act, which limited the categories of noncitizens eligible for the Medicaid and Medicare programs. Second, the U.S. Department of Health and Human Services (HHS) issued a notice reinterpreting a 1996 welfare reform law as rendering certain categories of noncitizens ineligible for, among other federal public benefits, the “health center program.” These policy changes coincided with a trend in some states toward more restriction of state-funded programs that had broadly supported services to noncitizens. In this session, we will clarify the scope of federal legislative and regulatory changes impacting health centers’ care for the noncitizen population, focusing on key definitions. We provide an overview of litigation in this area, and also describe trends seen at the state level. Finally, we will offer some tips on how health centers can navigate this shifting policy environment while still functioning as the vital primary care safety net in their service areas.
Learning Objectives:
Upon completion of the session, participants will be able to describe how a new federal interpretation of welfare reform laws has impacted rules on services to noncitizens.
Participants will be able to identify which categories of noncitizens are eligible for services under Medicaid, and how these parameters changed with the enactment of OBBBA
Participants will leave the session with some practical tips for navigating a changing policy environment.
