OK SPA 26-0012 and APA WF # 26-03 - H.R. 1 Alien Eligibility
The proposed policy revisions (State Plan Amendment and rule amendments) align with eligibility changes included in H.R. 1, also referred to as the Working Families Tax Cut legislation. Beginning October 1, 2026, federal financial participation (FFP) will only be available for Medicaid benefits 79furnished to United States citizens, lawful permanent residents (LPRs), certain Cuban/Haitian entrants, and citizens of the Freely Associated States covered under the Compact of Free Association (COFA). Most other non-citizens will no longer qualify for full-scope coverage and will be limited to Emergency Medical Assistance.
Please view the draft SPA draft here: 26-0012 and the draft rule amendments here: APA WF # 26-03
Please submit feedback via the comment box.
Circulation Date: 9/1/2026
Tribal Consultation: 5/6/2026
Comment Due Date: 9/15/2026
Requested Effective Date: October 1, 2026, contingent upon CMS approval.
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Please note that all comments must be reviewed and approved prior to posting. Approved comments will be posted Monday through Friday between the hours of 7:30 a.m. – 4 p.m. Any comments received after 4 p.m. will be posted on the following business day.
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