The main purpose of this legislation is to make immediate changes to Medicaid eligibility and funding related to non-citizens, specifically targeting those who are not legally in the United States. The bill aims to exclude undocumented immigrants from receiving Medicaid benefits and to adjust how states are reimbursed for providing healthcare to certain groups of non-citizens. Key provisions of the legislation include changing the effective date for when non-citizens become eligible for Medicaid. The bill moves this date up from October 1, 2026, to July 4, 2025.