Title: How Do Immigrants Obtain Health Insurance Under the ACA?
Headings: How Do Immigrants Obtain Health Insurance Under the ACA?
How Do Immigrants Obtain Health Insurance Under the ACA?
Some Different Rules Apply for Medicaid and for Premium Subsidies
Are ACA Premium Subsidies Limited to U.S. Citizens?
How Does the Exchange Know That Applicants Are Lawfully Present?
What Coverage Is Available for Immigrants Who Are 65 or Older?
Can an Immigrant Enroll in Coverage Outside of Open Enrollment?
Can Undocumented Immigrants Obtain Coverage?

Content: Unlike many other countries, the U.S. does not have universal health coverage, and although Medicare and Medicaid are government-sponsored health plans, they're not available to new immigrants. So let's take a look at some frequently asked questions about what's available for immigrants, including new arrivals and those who have been in the U.S. for a long time. GCShutter / istockphoto / Getty Images
Are ACA Premium Subsidies Limited to U.S. Citizens? No. Premium subsidies (premium tax credits) in the exchanges are available to lawfully-present residents, which includes a long list of immigration statuses (note that Deferred Action for Childhood Arrivals—DACA—is not considered an eligible immigration status for purchasing coverage in the exchange). 1 ﻿
In fact, premium subsidies are available to recent immigrants with income below the poverty level, which is not the case for non-immigrants or immigrants who have been lawfully present U.S. residents for more than five years. The ACA calls for people with income below the poverty level to receive Medicaid instead of private plans in the exchange, which is why premium subsidies generally aren't available to applicants with income below the poverty level. But recent immigrants aren't eligible for federally-funded Medicaid until they have been in the U.S. for at least five years (states have the option to use their own funding to extend Medicaid coverage to recent immigrants, which some do, particularly in the case of pregnant women). When the Affordable Care Act (ACA) was written, lawmakers realized that the ACA's lower-income threshold for premium subsidies (i.e., the poverty level) would leave recent immigrants with low incomes without any realistic coverage options. So they specifically provided for premium subsidies that would cover new immigrants with income below the poverty level.