Prior to the Affordable Care Act becoming law, many immigrants living in the United States — even those living here legally — did not have good access to affordable health care.
But under the new law, immigrants who are in the U.S. legally can now buy health insurance — and qualify based on income for premium subsidies and cost reductions — through their state’s health insurance exchange.
(Some states, like Virginia, use the federal health insurance exchange, whereas others, like Maryland and the District of Columbia, have their own exchange.)
Here are six questions about immigrants and health insurance under the Affordable Care Act.
Are Immigrants Required by Law to Have Health Insurance?
Yes, most legally present immigrants in the United States are subject to the Affordable Care Act’s individual mandate. If you are a legal immigrant, then you must have health insurance coverage by 2014 or pay a penalty tax.
Note that immigrants who are not lawfully present are not subject to the individual mandate.
What Makes an Immigrant Legally Present in Terms of Health Insurance?
You are considered lawfully present for purposes of health insurance if you are:
- A permanent resident (i.e., have been issued a “green card”)
- Fleeing persecution (includes refugees and asylees)
- Granted temporary protected status
- A Cuban/Haitian entrant
- A survivor of domestic violence, trafficking or other serious crimes
How Can an Immigrant Get Help Paying for Health Insurance?
Lawfully present immigrants are subject to the same income limits as citizens in order to be eligible for premium subsidies and cost-sharing assistance to help pay for health insurance.
If you earn between 100% and 400% of the federal poverty level you may be eligible for premium subsidies if you cannot get affordable health insurance through your employer. If you earn less than 100% of the federal poverty level, you may also be eligible for cost-sharing savings. Click here for more details.
Like citizens, in order to collect the subsidy, you must purchase your policy on your state’s health insurance exchange.
Note that undocumented immigrants cannot get help paying for health insurance and cannot get coverage, even at full price, on the exchange.
How Long Must an Immigrant Live in the U.S. Before Buying Health Insurance?
Unlike Medicaid, which requires legal immigrants to have lived in the U.S. for five years before they can collect benefits, immigrants can purchase health insurance on the exchange (with or without assistance) as soon as they have established permanent residency.
Is Citizenship and Immigration Status Checked?
Yes. When you apply for coverage through the exchange, your status is electronically verified.
Can an Illegal Immigrant Purchase Coverage for a Citizen Child?
Yes. Only those individuals that will be covered by a health insurance policy must provide proof of their status. For example, if you are an undocumented immigrant applying for coverage for your citizen child, you will not be required to provide your status.
Note that undocumented family members are not at risk when a lawfully present immigrant applies for health insurance through the marketplace, through Medicaid, or through CHIP (Children’s Health Insurance Plan).