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Page 6 – State Health Official Letter requirements.22 For example, states must provide full Medicaid benefits to Cuban/Haitian entrants for seven years after their grant date of Cuban/Haitian entrant status if they meet all other eligibility requirements in the state,23 and states have the option to provide full Medicaid benefits to Cuban/Haitian entrants beyond the seven year period.24 While section 1903(v)(5) of the Act places limits on the availability of FFP for full Medicaid and CHIP benefits for certain noncitizens beginning on October 1, 2026, the WFTC legislation did not amend: the definition of qualified alien in PRWORA;25 the limitation in PRWORA that eligibility for federal public benefits, including full Medicaid and CHIP benefits, is restricted to qualified aliens;26 or the applicability of the five-year waiting period (and exceptions thereto) to certain qualified aliens.27 States must continue to apply relevant eligibility rules in 8 U.S.C. §§ 1613 (for Medicaid and CHIP) and 1612 (for Medicaid, only) to those qualified noncitizens who are also FFP-eligible noncitizens. Therefore, on and after October 1, 2026, states must continue to apply the five-year waiting period to LPRs in accordance with 8 U.S.C. § 1613(a), unless an exception provided in 8 U.S.C. §§ 1613(b) or (d)(1) applies (e.g., LPRs who are veterans or active-duty armed forces service members or certain family members of such an individual28). States must continue to except Cuban/Haitian entrants and COFA migrants from the five-year waiting period.29 Similarly, states must continue to provide full Medicaid benefits to FFP-eligible noncitizens in accordance with 8 U.S.C. § 1612(b) (e.g., states must provide full Medicaid benefits to LPRs who have worked, or can be credited with, 40 qualifying quarters, and may elect to provide full Medicaid benefits to all LPRs30). Specifically, in accordance with 8 U.S.C. § 1612(b)(2), states must not apply additional eligibility limitations to certain FFP-eligible noncitizens (e.g., certain Indians who are LPRs31 and COFA migrants32). Section 71109 of the WFTC legislation did not amend the description in 8 U.S.C. § 1612(b)(2) of the populations to which states must provide full Medicaid benefits, nor did it amend the description or scope of the populations in section 1902 of the Act to which states are required to provide medical assistance33 (e.g., individuals to whom supplemental security income (SSI) benefits are being paid).

22 8 U.S.C. § 1612(b) specifies that it applies to Medicaid as a “designated federal program” defined at 8 U.S.C. § 1612(b)(3)(C). Since CHIP has never been identified as a “designated federal program,” we do not interpret the provisions of 8 U.S.C. § 1612(b) as applicable to separate CHIPs. 23 8 U.S.C. § 1612(b)(2)(A)(i)(IV). 24 8 U.S.C. § 1612(b)(1). 25 8 U.S.C. §§ 1641(b) and 1641(c). 26 8 U.S.C. § 1611(a). 27 8 U.S.C. § 1613. 28 8 U.S.C. § 1613(b)(2). 29 8 U.S.C. § 1613(b)(1)(D); 8 U.S.C. § 1613(b)(3). 30 8 U.S.C. § 1612(b)(2)(B). In accordance with 8 U.S.C. § 1613, LPRs must also meet the five-year waiting period, unless an exception applies. 31 8 U.S.C. § 1612(b)(2)(E). 32 8 U.S.C. § 1612(b)(2)(G). 33 In particular, states are required to provide medical assistance that includes at least the care and services described in sections 1905(a)(1)-(5), (13)(B), (17), (21), (28), (29), and (30) of the Act to individuals listed at section 1902(a)(10)(A) of the Act. (Section 1902(a)(10)(A) of the Act.)