Which states currently cover undocumented adults with full‑scope Medicaid‑like benefits and what benefits are included?
Executive summary
Six states have used state funds to provide Medicaid or Medicaid‑like coverage to at least some undocumented adults, but the specific programs, enrollment windows, and benefits vary widely and several high‑profile state programs have been paused or narrowed in 2025–2026 [1] [2] [3]. California and Minnesota are among the states most frequently cited in reporting, but recent state policy reversals and freezes mean the set of adults who can newly enroll — and the benefits available — are in flux [3] [4] [5].
1. Current landscape: a patchwork of state‑funded programs, not federal Medicaid
Federal law bars using federal Medicaid dollars to provide regular, comprehensive full‑scope Medicaid to undocumented immigrants, so the programs that do exist are almost always fully state‑funded or delivered through state‑level Medicaid‑like initiatives rather than the federal Medicaid match [6] [2]. Analysts and advocates describe a patchwork in which some states cover children and pregnant people broadly, a smaller set extend coverage to certain adult age groups regardless of status, and others limit undocumented adults to emergency or pregnancy‑related services only [7] [6].
2. Which states cover undocumented adults — the headline names and the caveats
Multiple sources report that six states have offered full Medicaid‑like coverage to some undocumented adults, but public reporting does not produce a single uncontested list in these excerpts; California and Minnesota are explicitly named in contemporary reporting as having created state‑funded adult expansions (California’s Medi‑Cal expansions and Minnesota’s short‑lived extension), while national trackers and maps (NILC, KFF) show additional states with adult programs or phased schedules [1] [3] [8] [2]. Crucially, states have recently tightened or paused enrollment: Minnesota paused enrollment for undocumented adults in June 2025 and planned to end coverage by January 2026, and California announced freezes and benefit changes that will restrict new adult enrollments beginning in 2026 [3] [4] [9].
3. What “full‑scope” or Medicaid‑like benefits mean in practice
Where states have consciously adopted “full‑scope” coverage for undocumented adults, those programs typically mirror the state’s Medicaid benefits — including primary care and preventive visits, hospital and emergency care, prescription drugs, mental health and substance use services, vision, immunizations, and reproductive health services — but the exact package is defined by state statute or program rules and can change [5] [6] [7]. For example, California’s guidance lists doctor visits, hospital services, prescriptions, behavioral health, vision, immunizations and reproductive health as part of full‑scope Medi‑Cal for eligible undocumented adults who enrolled under expansion rules [5].
4. Recent policy shifts that matter: freezes, benefit cuts, premiums and timelines
Several of the programs that expanded adult coverage have been altered: California announced a freeze on new full‑scope Medi‑Cal enrollment for undocumented adults 19+ starting January 1, 2026, a planned end to adult dental benefits in July 2026, and a proposed $30 monthly premium for certain adult members beginning July 2027 for those without “satisfactory” immigration status — while retaining protections for those already enrolled in good standing [4] [5]. Minnesota’s expansion was time‑limited: enrollment extended in January 2025 but paused June 2025 with a plan to terminate coverage by January 2026 [3]. These shifts illustrate how politically contingent and rapidly changing state programs are [3] [2].
5. Emergency Medicaid remains the floor, state programs the variable ceiling
For undocumented immigrants who are otherwise ineligible, Emergency Medicaid (paid for by traditional state/federal Medicaid processes when applicable) covers only services needed to stabilize an emergency medical condition; it does not provide ongoing, preventive, or routine care [6]. State‑funded programs that market themselves as “Medicaid‑like” are what expand routine care to undocumented adults, but their existence and scope depend on state budgets, politics and recent legislation [6] [2].
Conclusion: know the maps, expect change
Reliable national trackers (NILC, KFF) and state pages are the best sources to determine today’s precise list and benefits, because several programs are temporary or have been modified in 2025–2026; reporting confirms there are multi‑state efforts to provide full‑scope, state‑funded coverage to undocumented adults but the roster of who can newly enroll and what is covered is narrowing in some states, notably Minnesota and California per recent announcements [8] [3] [4] [5]. Where full‑scope coverage exists, it generally mirrors state Medicaid benefits, but federal restrictions and shifting state policy mean the landscape can change quickly [6] [2].