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To: Public Health and
Welfare
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Senator(s) Fillingane
SENATE BILL NO. 2198
AN ACT TO CREATE NEW SECTION 43-12-10, MISSISSIPPI CODE OF 1
1972, TO PROVIDE THAT NO INDIVIDUAL WHO IS NOT A UNITED STATES 2
CITIZEN OR A NATIONAL OF THE UNITED STATES SHALL BE ELIGIBLE FOR 3
PARTICIPATION IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM 4
(SNAP) OR FOR MEDICAID UNLESS THE INDIVIDUAL MEETS THE DEFINITION 5
OF AN ELIGIBLE ALIEN UNDER 7 USC § 2015(F) OR 42 USC § 1396B(V), 6
AS THE CASE MAY BE, AND MEETS THE DEFINITION OF A QUALIFIED ALIEN 7
UNDER 8 USC § 1641(B); TO REQUIRE THE DEPARTMENT OF HUMAN SERVICES 8
(DEPARTMENT) AND THE DIVISION OF MEDICAID (DIVISION) TO VERIFY 9
CITIZENSHIP OR ELIGIBLE ALIEN STATUS DURING ENROLLMENT AND 10
ELIGIBILITY REDETERMINATIONS; TO REQUIRE THE DEPARTMENT AND THE 11
DIVISION TO SUBMIT TO APPROPRIATE LAW ENFORCEMENT AUTHORITIES 12
INFORMATION CONCERNING ANY HOUSEHOLD MEMBER DETERMINED TO BE AN 13
UNLAWFULLY PRESENT ALIEN; TO REQUIRE THE DEPARTMENT AND THE 14
DIVISION TO SUBMIT INFORMATION CONCERNING ANY HOUSEHOLD MEMBER FOR 15
WHOM THEY ARE UNABLE TO VERIFY ELIGIBLE ALIEN STATUS; TO SET FORTH 16
INCOME AND FINANCIAL RESOURCES TO BE CONSIDERED IN DETERMINING 17
ELIGIBILITY FOR PARTICIPATION IN SNAP; TO REQUIRE THE DIVISION TO 18
ADHERE TO CERTAIN REQUIREMENTS REGARDING THE REASONABLE 19
OPPORTUNITY PERIOD FOR VERIFICATION OF UNITED STATES CITIZENSHIP 20
OR ELIGIBLE ALIEN STATUS FOR MEDICAID AND TO REQUIRE A FIELD FOR 21
CITIZENSHIP OR ELIGIBLE ALIEN STATUS ON ALL PRESUMPTIVE 22
ELIGIBILITY APPLICATIONS; TO DIRECT THE DIVISION TO REQUIRE 23
HOSPITALS THAT ACCEPT MEDICAID TO INCLUDE A PROVISION ON ADMISSION 24
OR REGISTRATION FORMS FOR INFORMATION ABOUT A PATIENT'S 25
CITIZENSHIP OR IMMIGRATION STATUS; TO PROVIDE THAT THE DIVISION 26
SHALL REQUIRE SUCH HOSPITALS TO SUBMIT QUARTERLY REPORTS THAT 27
INCLUDE THE NUMBER OF ADMISSIONS OR EMERGENCY DEPARTMENT VISITS 28
BASED ON CITIZENSHIP AND IMMIGRATION STATUS; TO REQUIRE THE 29
DIVISION TO SUBMIT ANNUAL REPORTS TO THE GOVERNOR, THE PRESIDENT 30
OF THE SENATE, AND THE SPEAKER OF THE HOUSE OF REPRESENTATIVES 31
THAT INCLUDE THE TOTAL NUMBER OF HOSPITAL ADMISSIONS AND EMERGENCY 32
DEPARTMENT VISITS FROM HOSPITALS THAT ACCEPT MEDICAID FOR THE 33
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PRIOR YEAR BASED ON CITIZENSHIP AND IMMIGRATION STATUS; AND FOR 34
RELATED PURPOSES. 35
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 36
SECTION 1. The following shall be codified as Section 37
43-12-10, Mississippi Code of 1972: 38
43-12-10. (1) As used in this section, "department" means 39
the Department of Human Services, and "division" means the 40
Division of Medicaid. 41
(2) No individual who is not a United States citizen or a 42
national of the United States shall be eligible for participation 43
in the Supplemental Nutrition Assistance Program (SNAP), unless 44
that individual meets the definition of an eligible alien under 7 45
USC § 2015(f) and meets the definition of a qualified alien under 46
8 USC § 1641(b). 47
(3) No individual who is not a United States citizen or a 48
national of the United States shall be eligible for Medicaid, 49
unless that individual meets the definition of an eligible alien 50
under 42 USC § 1396b(v) and meets the definition of a qualified 51
alien under 8 USC § 1641(b). 52
(4) The department shall be required to verify that an 53
individual is eligible under subsection (1) of this section and 54
the division shall be required to verify that an individual is 55
eligible under subsection (2) of this section during enrollment 56
and eligibility redeterminations by verifying citizenship or 57
eligible alien status using the Systematic Alien Verification for 58
Entitlements (SAVE) service or by requiring the individual to 59
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provide an acceptable form of proof of citizenship or eligible 60
alien status, including, but not limited to, certified birth 61
certificates, United States passports and United States 62
Citizenship and Immigration Services documentation. 63
(5) The department and the division shall submit to the 64
appropriate law enforcement authorities, including, but not 65
limited to, the United States Department of Homeland Security, 66
information concerning any household member that the department or 67
the division, as the case may be, has determined to be an 68
unlawfully present alien, regardless of whether such household 69
member is applying to participate in the program as a member of 70
such household. 71
(6) The department shall submit to the United States 72
Department of Agriculture information concerning any household 73
member for whom it is unable to verify eligible alien status, 74
regardless of whether such household member is applying to 75
participate in SNAP as a member of such household. 76
(7) The division shall submit to the United States 77
Department of Health and Human Services information concerning any 78
household member for whom it is unable to verify eligible alien 79
status, regardless of whether such household member is applying 80
for Medicaid as a member of such household. 81
(8) The entire income and financial resources of any 82
individual rendered ineligible for participation in SNAP under 7 83
USC § 2015(f) shall be considered in determining the eligibility 84
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and benefit allotment of the household of which such individual is 85
a member. 86
(9) The division shall adhere to the following requirements 87
regarding the reasonable opportunity period for verification of 88
United States citizenship or eligible alien status for Medicaid: 89
(a) When an applicant's status cannot be verified 90
through available data sources, the division shall provide only a 91
single reasonable opportunity period, consistent with the minimum 92
period required under federal law, for the applicant to provide 93
verification. 94
(b) Medicaid coverage may only be provided on a 95
provisional basis during the reasonable opportunity period. 96
(c) Failure to submit acceptable documentation within 97
the reasonable opportunity period required under federal law shall 98
result in denial or termination of Medicaid eligibility, subject 99
to required notice. 100
(d) No additional reasonable opportunity period shall 101
be granted to any applicant who has previously been denied 102
eligibility at any time due to a failure to verify citizenship or 103
eligible alien status. 104
(10) The division shall require a field for citizenship or 105
eligible alien status on all presumptive eligibility applications. 106
The division shall require hospitals, clinics, and other qualified 107
entities authorized to conduct presumptive eligibility 108
determinations to collect and transmit attestations of citizenship 109
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or eligible alien status to the division. No presumptive 110
eligibility application shall be approved unless the applicant 111
certifies that he or she is a United States citizen, United States 112
national, or alien eligible for Medicaid under 42 USC § 1396b(v) 113
and subsection (3) of this section. 114
(11) The division shall: 115
(a) Require each hospital that accepts Medicaid to do 116
all of the following: 117
(i) Include a provision on its patient admission 118
or registration forms for the patient or the patient’s 119
representative to state or indicate whether the patient is a 120
United States citizen or lawfully present in the United States or 121
is not lawfully present in the United States. 122
(ii) Notify a patient, at the time the information 123
under subparagraph (i) of this paragraph (a) is collected, that 124
any submission made on an admission or registration form will not 125
affect patient care, as required by federal law. 126
(iii) Submit a quarterly report to the division 127
within thirty (30) days after the end of each calendar quarter 128
that includes the number of hospital admissions or emergency 129
department visits within the previous quarter that were made by a 130
patient or a patient’s representative who indicated that the 131
patient was a United States citizen or lawfully present in the 132
United States, that the patient was not lawfully present in the 133
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ST: SNAP and Medicaid benefits; confirm status
as eligible alien under federal law to be
eligible for.
United States, or that the patient or patient's representative 134
declined to answer. 135
(b) By April 1 of each year, submit a report to the 136
Governor, the President of the Senate, and the Speaker of the 137
House of Representatives that includes the total number of 138
hospital admissions and emergency department visits from hospitals 139
that accept Medicaid for the previous calendar year for which the 140
patient or patient’s representative reported that the patient was 141
a United States citizen or lawfully present in the United States, 142
that the patient was not lawfully present in the United States, or 143
that the patient or patient's representative declined to answer. 144
The report must also describe information relating to the costs of 145
uncompensated care for aliens who are not lawfully present in the 146
United States, the impact of uncompensated care on the cost or 147
ability of hospitals to provide services to the public, hospital 148
funding needs and other related information. 149
(c) Adopt rules relating to the format and information to be 150
contained in quarterly reports under paragraph (a)(iii) of this 151
subsection (11) and the acceptable formats for hospitals to use in 152
requesting information regarding a patient’s immigration status on 153
hospital admission or registration forms. 154
SECTION 2. This act shall take effect and be in force from 155
and after July 1, 2026. 156