Which states had Medicaid-like programs for undocumented adults as of 2025?

Executive Summary — Short Answer Now: As of mid‑2025, a core group of states and Washington, D.C. have state‑funded, Medicaid‑like programs that cover some undocumented adults, but the list and scope vary by source and by program design. Major analyses around May–September 2025 identify California, New York, Oregon, Washington, Illinois, Massachusetts, Maine, Vermont, Minnesota, Colorado, Connecticut, Rhode Island, New Jersey, and Utah among jurisdictions that provide at least some adult coverage or have expanded programs, with important differences in who is covered and how programs are financed ^{[1] [2] [3] [4]}.

1. How big is the “who covers undocumented adults” disagreement? The headline numbers diverge. Multiple reputable analyses published in spring and summer 2025 converge on the same core finding: several states plus D.C. have used state‑only dollars to furnish Medicaid‑like benefits to some undocumented adults, but they differ on counting methodology. Two KFF analyses from May 22, 2025 report that seven states plus D.C. cover at least some adults regardless of immigration status, flagging California, Illinois, Massachusetts, New York, Oregon, Washington, and either Rhode Island or Vermont depending on the dataset ^{[1] [2]}. A separate KFF summary updated in late May 2025 lists a slightly different set, and a September 2025 KFF brief expands the roster to include Colorado and Minnesota alongside the others ^[3]. The variation reflects different definitions—whether the state covers all adults, only certain age bands, or only limited benefits—so headline counts ^{[5] [6] [7]} are all defensible under different criteria ^{[1] [3] [4]}.

2. Who’s consistently on the short list? Core states across sources. Across the datasets, California, New York, Oregon, Washington, Illinois, and Massachusetts repeatedly appear as states providing adult coverage of undocumented immigrants in at least some form; Maine, Vermont, Minnesota and Colorado appear in several trackers as well ^{[1] [2] [3] [4]}. Washington, D.C. is consistently listed as offering comparable coverage. The consistent pattern is that states have reached similar policy endpoints—state‑only funding to cover adults ineligible for federal Medicaid—while program rules (age caps, benefit limits, enrollment pauses) differ, which explains disagreements in counts and in whether a state is called a “Medicaid‑like” provider for undocumented adults ^{[1] [3] [4]}.

3. California’s expansion: the largest and most publicized example, but it’s changing. California enacted the most expansive adult coverage expansion in 2025, promising full‑scope Medi‑Cal to undocumented adults up to age 49 and projecting multi‑billion dollar annual costs and hundreds of thousands of enrollees; this made California the first state to promise broad adult coverage for undocumented immigrants and dominated media and policy attention early in 2025 ^[8]. However, by mid‑late 2025 state budget pressures produced policy shifts: reports indicate planned pauses or program changes (e.g., enrollment pauses for certain cohorts starting January 2026), showing policy volatility even in the most expansive program ^{[3] [8]}. That underscores the difference between a legal commitment and the operational reality of enrollment and sustained funding.

4. Federal policy proposals and state budget realities are reshaping the landscape. Analyses published in May 2025 flagged a proposed federal Medicaid match penalty that would target states expanding coverage for undocumented immigrants; KFF estimated the penalty could affect multiple states and potentially put more than 1.9 million people at risk if states scaled back to avoid penalties ^{[1] [2]}. By September 2025, KFF and other trackers documented states reacting to fiscal pressures: Illinois ended its Health Benefits for Immigrant Adults program in July 2025, and other states have considered or implemented rollbacks and enrollment pauses ^[3]. The policy takeaway is dynamic: the roster of states offering adult coverage is not fixed and is sensitive to federal incentives and state budgets.

5. What to tell a reader who wants a definitive list today? Read the fine print. If you need a precise, up‑to‑the‑moment count, consult state program rules and the latest trackers: KFF’s May–September 2025 briefs and policy maps (which list core states and note caveats) plus contemporaneous reporting that enumerates broader state actions (news summaries listing 14 states and D.C.) are the best starting points ^{[1] [2] [3] [4]}. Remember that many states provide only limited or group‑specific coverage (pregnant people, certain age bands, or capped enrollment), while a smaller set provide broad adult coverage. Any authoritative claim must specify whether it counts full‑scope adult coverage, partial benefits, or child‑only coverage, since different sources use different thresholds.