During the 2025 and 2026 legislative sessions, states enacted or proposed a range of legislation that will impact immigrants’ access to state-funded health coverage and other services as well as actions related to how states may enhance or limit federal enforcement activities. Several states have rolled back or plan to scale back state-funded health coverage programs for immigrants to reduce budget deficits amid economic uncertainties. Some states have also enacted laws to support the Trump administration’s increased interior immigration enforcement activities, including sharing data from Medicaid or other state agencies with federal enforcement officials. In contrast, some states are expanding access to health coverage or other benefits for immigrants, including lawfully present immigrants losing eligibility for federally funded health coverage under the 2025 reconciliation law, and/or enhancing protections for immigrants. While some states are seeking to enhance protections for immigrants, the Trump administration signed an executive order directing federal agencies to suspend federal grants and contracts with states or local jurisdictions identified as obstructing enforcement of federal immigration laws, or “sanctuary jurisdictions.” So far federal challenges to state and local sanctuary jurisdictions have largely failed. However, the federal stance may limit state or local actions.
This brief summarizes recent and proposed actions by states related to access to state-funded health coverage and other services for immigrants and immigration enforcement activity during the 2025 and 2026 legislative sessions. It reflects activity as of June 2026 based on KFF analysis of publicly available materials and the National Conference of State Legislatures’ Immigration Legislation Database. Several state legislatures were still in session as of June 2026, so additional actions may be taken during the 2026 session that are not reflected here. Additionally, states may have implemented similar policies prior to their 2025 legislative session that are not included.
Access to State-Funded Health Coverage and Other Services
As of June 2026, six states, including DC, have recently eliminated, reduced, or plan to scale back state-funded health coverage for immigrants due to budget pressures. Economic uncertainties and federal funding reductions that may reduce state revenues and the rising costs of health care and social services have driven states across the country to consider measures to reduce spending. Some states have eliminated or plan to eliminate coverage for some adults in their state funded coverage programs for immigrants, including Illinois, Minnesota, and DC. Several states have closed enrollment or reduced enrollment caps or income eligibility limits for some adults in their state-funded programs for immigrants, including California, Colorado, DC, and Washington. In California, some adults remaining in the program will face cuts to dental benefits and new premiums, and the governor has proposed implementing work requirements and more frequent six-month renewals, which would align with new Medicaid requirements under the 2025 reconciliation law, as well as further increasing premiums for some adults. A few states are reducing coverage for immigrant children and pregnant people. Colorado plans to cap enrollment and limit benefits for state-funded coverage for immigrant children and pregnant people beginning in January 2027. Additionally, North Carolina enacted a Medicaid funding bill in April 2026 that limited immigrant eligibility to coverage that the state is federally required to provide starting October 1, 2026. This would eliminate the state’s optional Medicaid coverage for lawfully residing children and pregnant women without a five-year wait. However, the governor has called for the state legislature to reinstate this coverage and some state legislators have indicated that the coverage cut was unintentional. These program reductions will likely have negative impacts on health care access and outcomes as research suggests that coverage expansions for immigrants are associated with lower uninsured rates and improved access to care.
In contrast, three states have plans to expand state-funded coverage to fill gaps in benefits that will be created by the 2025 reconciliation law eligibility restrictions for lawfully present immigrants. New Mexico plans to use state funds to cover Deferred Action for Childhood Arrivals (DACA) recipients who have already been ineligible for federally funded health coverage and lawfully present immigrants who will lose Medicaid, subsidized Affordable Care Act (ACA), and Supplemental Nutrition Assistance Program (SNAP) benefits under the 2025 reconciliation law. New York plans to use state funds to cover lawfully present immigrants losing Medicaid coverage and federally-subsidized health coverage through its Essential Plan. Under a longstanding court ruling, New York is required to provide state-funded coverage to lawfully present immigrants who would be eligible for Medicaid except for their immigration status. Additionally, Washington increased funding for the state-funded Food Assistance Program, which provides the same benefits as SNAP, in order to provide assistance to lawfully present immigrants who were eligible for SNAP benefits prior to the 2025 reconciliation law changes. California governor’s 2026-27 budget proposes using state funds to continue providing nutrition assistance to immigrants who were eligible for state-funded assistance prior to the 2025 reconciliation law and to offer assistance to income-eligible individuals age 55 and older regardless of immigration status starting October 1, 2027.
As of June 2026, some states have enacted legislation that would limit immigrant access to certain other benefits. In 2025, Idaho enacted legislation that decreases the maximum income refugees can earn to remain eligible for the Refugee Medical Assistance program from 150% to 133% of the federal poverty level. Idaho also enacted legislation preventing undocumented immigrants from accessing certain public benefits that were previously exempt from immigration status verification, including publicly funded vaccinations, communicable disease testing, prenatal and postnatal care, crisis counseling, and food assistance for children. Florida enacted legislation that made undocumented immigrants ineligible for in-state tuition rates at the state’s public universities as of July 2025. Tennessee enacted legislation that will hold churches and charitable organizations liable for providing housing aid to immigrants without legal status who commit crimes.
In contrast, several states have enacted legislation to coordinate or increase access to benefits and services for certain immigrants, including refugees, military members, youth, and aging immigrants. In 2025, Massachusetts enacted legislation requiring resettlement agencies to coordinate the provision of services to immigrant and refugee families and pregnant women. New York enacted legislation to direct its Military Immigrant Family Legacy Program to connect noncitizen military members and their families to immigration legal assistance. Utah created a new Refugee Services Office to coordinate services and benefits available to refugees. California will fund legal counsel for certain noncitizen immigrant youth and direct the state’s Department of Aging to identify recommendations to support older and aging immigrants.
Some states have taken action to protect or facilitate immigrants’ access to educational opportunities. In 2025, Oregon enacted legislation exempting asylum seekers enrolled in the state’s public universities from paying non-resident tuition and fees, and Colorado passed legislation that removed a requirement for immigrants to attest that they have applied or will apply for lawful presence when applying for in-state tuition at the state’s public universities. Oregon also enacted legislation in 2026 that would prevent school boards from declining to admit immigrant children due to their immigration status and adds immigration status as a protected class under anti-discrimination law. New York and Virginia enacted legislation protecting the right to education regardless of immigration status, with Virginia also prohibiting discrimination against students based on immigration status.
Several states have also passed legislation to enhance immigrants’ access to the workforce, including the health care workforce. Washington and Oklahoma enacted legislation in 2025 that would allow international medical graduates to practice in health care facilities in certain situations. An executive order by Washington’s governor also established a state Office of Equity to support coordination between state agencies responsible for implementing services for immigrants, including education, entrepreneurship, licensing, and workforce training. Hawaii and Rhode Island created a pathway for certain foreign medical school graduates to receive medical licensure, and Maine enacted legislation to direct the state to identify alternative pathways for foreign dentists to receive licensure. Wisconsin repealed restrictions on DACA recipients from working in jobs that require professional licensure, such as nursing. New Mexico established a New Americans division in the state Workforce Solutions Department to assist with expanding educational, workforce training and other initiatives for immigrants and to study their economic impact on the state.
Immigration Enforcement and Data Sharing
Several states have enacted legislation or executive orders to enhance immigration enforcement activities, building on state actions taken in prior years and multiple Trump administration executive orders directing federal agencies to take punitive actions against states and cities that limit cooperation with federal immigration enforcement. For example, Florida and Indiana passed legislation in 2025 that enhances criminal penalties for undocumented immigrants who are convicted of certain crimes. In 2026, Idaho passed legislation that would make it a state crime for noncitizens to enter or remain in the state after violating federal immigration laws, and Tennessee added a criminal penalty for someone who remains in the state after receiving a federal deportation order. Some states have prohibited localities and state entities from implementing policies that would limit cooperation with federal immigration enforcement authorities for civil immigration law violations, often referred to as sanctuary policies, including North Dakota, New Hampshire, Indiana, and Mississippi. Additionally, some states passed legislation to promote cooperation with federal immigration enforcement. New legislation in Kansas allows local law enforcement to enter into agreements with federal immigration enforcement authorities without local approval. Legislation in Mississippi directs the state’s Department of Public Safety to identify the number of undocumented immigrants residing in the state and requires all local detention facilities to enter into agreements with federal immigration enforcement. Governor executive orders in Texas and Nebraska also direct law enforcement and state agencies to cooperate with federal immigration enforcement.
Some states have implemented increased immigration verification requirements for driver’s licenses and voting, continuing earlier trends of driver’s licensure laws impacting immigrants. For example, Wyoming enacted legislation in 2025 invalidating driver’s licenses held by undocumented immigrants that were issued out-of-state, and Tennessee enacted legislation to publish lists of out-of-state driver’s licenses issued to undocumented immigrants that would be invalid in Tennessee. States have also enacted legislation related to voting. Legislation in Kansas creates a database of noncitizens holding driver’s licenses that would be cross-referenced with voter registration rolls to identify ineligible voters, and Alabama prohibits foreign driver’s licenses from being used as voter identification. Several states, including Mississippi, South Dakota, and Wyoming, enacted legislation since 2025 that would allow the state to verify immigration status during voter registration either by using the Department of Homeland Security’s (DHS) Systematic Alien Verification for Entitlements (SAVE) system or by requiring applicants to provide documentation of citizenship.
In addition to enhanced enforcement and verification measures, several states have also implemented new requirements for state agencies to share data on immigrants with federal immigration enforcement officials or statewide databases. Missouri enacted legislation in 2025 that requires law enforcement to include the citizenship or immigration status of anyone arrested in reports submitted to the statewide crime reporting system, building on the Missouri governor’s executive order earlier in the year to expand analysis of crimes committed by undocumented immigrants. In 2026, Indiana, Louisiana, North Carolina, Tennessee, and Wyoming enacted legislation and Oklahoma’s governor issued an executive order requiring state agencies to report applicants or recipients of Medicaid and/or other public benefits whose immigration status could not be verified and/or who were verified to not have lawful presence to DHS or other federal authorities, or in the case of Tennessee, to a central state immigration enforcement agency. In Indiana and Wyoming, reporting may also include applicants’ household members determined to not be lawfully present. Tennessee also makes it a crime for government employees to not report undocumented immigrants to the central state immigration enforcement authority, and local governments could lose state funding if the state determines that they are not complying with state law.
In contrast, some states have enacted legislation and executive orders to limit federal immigration enforcement and/or collection or sharing of data for immigration enforcement purposes in certain settings, such as health care facilities and schools. California, Colorado, Maryland, New Jersey, New York, and Oregon have enacted legislation limiting civil immigration enforcement activity in “sensitive locations,” such as schools, health care facilities, libraries, courthouses, and places of worship. These state actions respond to a prior federal policy limiting federal immigration enforcement in sensitive areas that was eliminated by the Trump administration. New York’s legislation also prohibits local jails from detaining individuals on civil immigration charges. Illinois enacted legislation that bans civil immigration enforcement inside and near public areas such as state courthouses, hospitals, and colleges. California, Illinois, New Jersey, and Oregon enacted legislation requiring health care facilities to treat immigration status as protected health information, which would limit sharing personal data for immigration enforcement purposes, and to set protocols for when immigration enforcement officers appear on hospital grounds. Oregon also prohibits hospitals from retaliating against employees who share information about immigration legal services with patients. Rhode Island enacted legislation prohibiting health care facilities from asking patients about their immigration status or for proof of lawful presence in the U.S. Illinois and Oregon enacted legislation requiring school districts and colleges to develop an alert system to notify students and parents if federal agents appear on school property, and Connecticut and Delaware enacted legislation requiring every school to have a designated administrator and plan for interacting with federal immigration authorities and prohibiting public schools from sharing student information without a warrant. Pending court cases have challenged state policies asserting that they conflict with federal law, but recent federal actions against these states and local jurisdictions have not survived legal challenges.
Some states have also taken action to limit state agencies or localities from entering into enforcement agreements and/or data sharing for federal immigration enforcement purposes. Colorado, Illinois, New Jersey, and Oregon enacted legislation that prohibit state agencies from collecting immigration status information unless required by law, and from disclosing personally identifying information for federal immigration enforcement purposes. Oregon also enacted legislation barring landlords from collecting immigration status information from rental applicants or tenants and from disclosing confidential information with very limited exceptions. Vermont enacted legislation that would prohibit state agencies from entering into agreements with federal immigration enforcement without the governor’s approval. Maryland, New Mexico, and New York enacted legislation that prohibit local entities from creating agreements with federal immigration enforcement. Maryland also enacted legislation prohibiting local correctional facilities from notifying federal immigration enforcement about certain immigrants in their custody and legislation prohibiting state and local agencies from sharing certain personal information with individuals or agencies involved in civil immigration enforcement. Governor executive orders in Massachusetts and New Jersey would also limit state engagement with federal immigration enforcement. An executive order by Washington’s governor directed state agencies to ensure compliance with previously enacted state law, which limits state agencies from collecting immigration status data and from disclosing non-public personal information for federal immigration enforcement purposes, and created a new cross-agency office to coordinate the state’s response to matters such as immigrant data privacy.
