Which 14 states currently offer health coverage to undocumented children or pregnant people, and what are the enrollment rules in each state?
Executive summary
Fourteen states (commonly listed as California, New York, Illinois, Washington, New Jersey, Oregon, Massachusetts, Minnesota, Colorado, Connecticut, Utah, Rhode Island, Maine and Vermont) have state programs that provide health coverage to people regardless of immigration status—including children and, in many cases, pregnant people—by using state-only funds or special CHIP options rather than federal Medicaid for undocumented migrants [1] [2] [3]. The specifics of who is eligible and how to enroll vary widely by state, and federal rules continue to bar undocumented immigrants from federally funded Medicaid, Marketplace subsidies, and Medicare, so these programs rely on state decisions and limited federal CHIP prenatal options [4] [5] [6].
1. Which 14 states are usually counted as providing state-funded coverage
Newsweek and the California Health Care Foundation both identify fourteen states offering some form of state-funded coverage to people with “unsatisfactory” or undocumented immigration status—those lists include California, New York, Illinois, Washington, New Jersey, Oregon, Massachusetts, Minnesota, Colorado, Connecticut, Utah, Rhode Island, Maine and Vermont [1] [2]. NILC maintains maps and a state-by-state table that illustrate which states use state funds or federal CHIP/Medicaid options to cover children and pregnant people, and those resources should be consulted for official program names and up-to-date boundaries [7] [3].
2. Common enrollment rules and eligibility patterns across these states
Across the states that cover undocumented children or pregnant people, coverage is typically limited by income and age (children up to a state-defined age) and is most often paid for with state-only dollars or via CHIP options that permit prenatal coverage regardless of status (the FCEP/CHIP option) rather than federal Medicaid for undocumented adults [6] [3]. Many programs restrict eligibility to state residents who meet income thresholds; some programs cover prenatal care through CHIP “from conception to end of pregnancy” rules, which federal guidance allows regardless of immigration status [6] [8].
3. Federal constraints that shape state enrollment rules
Federal law generally prohibits using federal Medicaid funds for undocumented immigrants, so states that cover undocumented people do so with state funds or by drawing limited federal matching funds for specific groups (e.g., CHIP prenatal care or CHIPRA 214 options for lawfully residing children/pregnant people) —this is why program scope is limited to children and pregnant people in many places [4] [9] [6]. Recent and pending federal policy changes (summarized by Georgetown/CCF and KFF) further restrict federal funding for some lawfully present immigrants beginning in 2026–2027, increasing the fiscal pressure on states and potentially altering enrollment rules [4] [10].
4. Notable state-level operational changes and caveats
California, despite being the first large state to offer full-scope Medi-Cal to low-income residents regardless of immigration status, announced a freeze on new enrollment for undocumented adults 19+ starting January 2026 and other benefit changes and premium proposals—demonstrating how budget pressures can quickly alter enrollment rules [10] [11]. Minnesota also paused enrollment for undocumented adults in mid‑2025 and planned to end coverage by January 2026, underscoring that program availability can be temporary or conditional [10].
5. Data gaps, practical steps to confirm current enrollment rules
Public reporting makes clear which states have programs in principle, but granular rules (age cutoffs, income brackets, documentation required, whether pregnancy coverage includes postpartum care, and exact enrollment procedures) differ by state and change frequently; NILC’s state maps and medical assistance table, KFF’s state trackers, and state Medicaid/CHIP offices are the definitive sources for current enrollment criteria and application processes [7] [3] [12]. Reporting also shows that while all 14 states and DC cover children under these programs, only a subset cover adults—including pregnant adults—so investigators must check each state’s program page for precise eligibility [2].
6. Competing perspectives and political pressures
Proponents frame state-funded coverage as lifesaving public‑health policy and cost‑effective by preventing emergency care churn, while opponents and some federal proposals argue such programs strain state budgets and seek federal penalties or restrictions—an implicit fiscal and political tug-of-war driving program design and enrollment limits at the state level [6] [4] [10]. Readers should treat any single list as a snapshot and consult state agencies or NILC/KFF for enrollment forms and the latest rule changes [7] [3] [12].