This legislation significantly expands Medicaid eligibility, making all individuals from birth until age 26 eligible for the program. It mandates that states automatically enroll children born within their borders into Medicaid, with provisions for parents or guardians to opt out if the child has comparable alternative health coverage. This expansion aims to ensure continuous health coverage for young people throughout their formative years. To support this expanded coverage, the bill requires states to provide medical assistance to eligible individuals under 26 regardless of their immigration status , prohibiting debt accrual under affidavits of support. Furthermore, it provides 100 percent federal matching payments for medical assistance costs for individuals who become newly eligible for Medicaid under these provisions. This enhanced federal funding is intended to incentivize states to implement the expanded eligibility and automatic enrollment. The act also extends continuous eligibility for Medicaid to individuals up to age 26 and expands the availability of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services to this age group. It exempts individuals under 26 from any community engagement requirements for Medicaid eligibility. Additionally, individuals eligible for this new Medicaid category but not enrolled will not be considered to have minimum essential coverage for purposes of Affordable Care Act premium tax credits.