Immigrants and the Affordable Care Act

There are many questions surrounding the Affordable Care Act (“ACA” or the “Act”), and one common question is how it affects immigrants.  Naturalized citizens are treated exactly like U.S. born citizens under the Act, and undocumented immigrants remain ineligible for almost everything except emergency care. There are different requirements for lawful permanent residents (LPRs) under the ACA.  Below is a list of some of these requirements:

LPRs are subject to the individual mandate and related tax penalty.  There are exemptions for low-income individuals and others.  

  • LPRs may enroll in a “qualified health plan” (QHP) from the state insurance exchanges and are eligible for premium tax credits and lower copayments.
  • There is no waiting period for enrolling in state insurance exchanges or premium tax credits.
  •  LPRs are eligible for the Pre-Existing Condition Insurance Plan (PCIP) and the Basic Health Plan (in certain states).
  • The five-year waiting period for most lawfully residing, low-income immigrant adults and other restrictions on Medicaid are still in effect, though states can elect to provide benefits to children and pregnant women without a waiting period.

Additionally, there are various requirements under the Act for when and how to verify immigration status in connection with health insurance.  For example, citizenship or lawful presence must be verified for all immigrants enrolling in private health insurance in the state exchanges, health insurance premium tax credits, Medicaid, and the Children’s Health Insurance Program (CHIP). Immigration status information, however, can only be used to verify eligibility.  It will not be used for other purposes.

For more information on the requirements for application and verification under the ACA, please see the National Immigration Law Center Fact Sheet or contact our office.


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