What state-level programs provide health coverage or cash assistance to undocumented immigrants, and which states offer the broadest access?
Executive summary
A growing but still limited patchwork of state-funded programs and waivers provide health coverage to some undocumented immigrants—mostly through a handful of states that fund full-scope coverage for adults or open state exchanges to those without lawful presence—while cash-assistance options remain rare and largely unavailable at the federal level [1] [2] [3]. Which states truly offer the broadest access is in flux: a core group of about a dozen–plus jurisdictions have created explicit coverage for undocumented people, but recent state pauses, program cuts, and federal policy changes in 2025–2026 have narrowed access and increased uncertainty [4] [5] [6].
1. State programs that extend health coverage to undocumented adults: a modest list with high visibility
States that have used state dollars or authorized programs to provide full‑scope health coverage to undocumented adults include a concentrated set—often reported as 14 states plus D.C.—with California, New York, Illinois, Washington, New Jersey, Oregon, Massachusetts, Minnesota, Colorado, Connecticut, Utah, Rhode Island, Maine and Vermont repeatedly named in reporting as offering some form of coverage to undocumented residents [4] [1]. Some states established separate, Medicaid‑like state programs (for example, Illinois’ Health Benefits for Immigrant Adults program), and others used state funding to extend Medi‑Cal‑style benefits; however, even these programs have faced recent retrenchment—California and Minnesota implemented enrollment freezes or benefit cuts in 2025–2026 and Illinois has proposed eliminating its HBIA amid budget pressures [5] [6] [7].
2. Children and pregnant people: broader state action but still uneven
Far more states have adopted policies to cover immigrant children and to provide prenatal care regardless of immigration status than have opted to cover nondisabled undocumented adults, with at least 14 states providing Medicaid/CHIP or state‑funded equivalents to children and many states electing CHIP options or state funds to cover prenatal care [8] [1]. National organizations’ state tables and maps show more extensive rules for lawfully‑present children and pregnant people under federal options, and state‑only programs often prioritize these populations even when adult coverage is restricted [8] [1].
3. State exchange waivers and marketplace access as an alternative route
Some states have sought federal waivers or approvals to allow undocumented residents to buy into state marketplaces or to receive state subsidies; Washington and Maryland succeeded in gaining federal permission to enroll undocumented residents through their state exchanges, and Colorado has used waiver mechanisms to subsidize those ineligible for federal premium tax credits [9] [2]. These marketplace routes can expand access without changing Medicaid rules, but they depend on federal approvals, time‑limited permissions, and state funding allocations [9] [2].
4. Cash assistance for undocumented immigrants: largely absent at the state level in the public record
Federal law has long barred undocumented immigrants from most federal cash assistance programs, and the provided reporting does not document a comprehensive list of state‑run cash assistance programs specifically for undocumented adults; where cash aid is available it tends to be narrow, targeted (e.g., disaster relief, local emergency funds), or limited to benefits for U.S. citizen children in mixed‑status households [3] [10]. NILC and policy trackers emphasize that TANF, SNAP and other major cash programs remain governed by federal eligibility rules and that states can only use state funds in narrowly defined ways—reporting here does not supply a broad inventory of state cash programs for undocumented adults [3] [10].
5. Who offers the broadest access—and why the picture is unstable
Based on state maps and national reporting, the broadest access currently exists in a cluster of states that have explicitly enacted state‑funded adult coverage or otherwise opened state exchanges: California, New York, Illinois, Washington, Oregon, Massachusetts, Colorado, Minnesota, New Jersey, Connecticut, Utah, Rhode Island, Maine and Vermont [4] [1]. Yet the “broadest” label is time‑sensitive: several of these states paused enrollments, cut benefits, or face federal policy changes (H.R.1 and related rules) that narrow eligibility for lawfully present immigrants and reduce federal matching funds for certain services beginning in late 2025–2026—so program reach and sustainability are contested political choices, not settled entitlements [5] [11] [12]. Reporting does not provide an exhaustive, up‑to‑the‑minute catalog of every local cash assistance program, and states’ program details are subject to rapid change; anyone relying on these programs should consult state agencies or NILC’s state tables for the most current rules [8] [1].