Undocumented Access in Federal

H.R. 1 Ends Federal Medicaid Match for Asylees, Refugees, and DACA Recipients — October 1, 2026

The House-passed reconciliation bill eliminates the federal financial participation (FFP) match for 'lawfully present' immigrants — including DACA recipients, asylees, and refugees — effective October 1, 2026. This is distinct from existing restrictions on undocumented immigrants: these populations currently receive full federal Medicaid matching funds. California FQHCs serving significant DACA and refugee populations (particularly in LA, San Diego, Central Valley) will face acute revenue loss when federal reimbursement disappears for this group — even if California chooses to continue state-only funding.

FQHCs Exempt from New $35 Medicaid Copays — Competitive Advantage

Under H.R. 1, states can impose up to $35 copays on Medicaid visits — but FQHCs are exempt by statute. This creates a significant competitive advantage: patients will face copays at hospitals and private clinics but not at FQHCs. Health centers should proactively market this exemption to attract and retain patients.