Key Take Aways
The ACA gave U.S. citizens and "lawfully present" immigrants the ability to enroll in a health coverage plan through the Marketplace.
Undocumented immigrants are not eligible for ACA coverage but are eligible for other types of health coverage.
Some states have programs to aid undocumented immigrants in finding health coverage.
There are multiple different health coverages that provide health insurance to those ineligible for ACA coverage.
How ACA gave access to health coverage to immigrants
Many immigrants consider getting health insurance through the Marketplace a far-off chance, if not impossible. Yet under the Affordable Care of 2010 (ACA), individuals who are "lawfully present" in the United States are eligible to enroll for health coverage through the Marketplace and may even qualify for premium tax credits. In July 2012, the Department Health and Human Services term then defined in more detail, which generally matches the definition in place for Medicaid and the Children's Heal Insurance Program. Under HHS' definition, a "lawfully present" individual includes those classified as "qualified" immigrants and other non-U.S. citizens who have permission to live and/or work in the United States.
Qualified "Lawfully Present" Immigrants for ACA Coverage
People with the following statuses and who have employment authorization also qualify for the Marketplace:
Note: DACA recipients are considered lawfully present during their deferred action period but are not eligible to enroll in health coverage through the exchange.
Can undocumented immigrants apply for ACA coverage?
No, while the ACA provides coverage for U.S. citizens and "lawfully present" immigrants, it does not provide any coverage for undocumented immigrants. There are specific exchanges such as (section 1312(f)(3)) which states
"ACCESS LIMITED TO LAWFUL RESIDENTS.—If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange."
Undocumented Immigrants are also not eligible for Medicaid under Federal guidelines. However, some states have implemented programs to cover low-income undocumented immigrants, particularly children and/ or pregnant people. Several states use their funds to provide Medicaid coverage to low-income undocumented immigrants. Some examples of this include but are not limited to California with its MediCal program, New York's Child Health Plus, and Oregon's Cover All Kids program.
It is also important to note that Healthcare.gov clarifies that immigration information provided to the MarketplaceMarketplace during the enrollment and verification process is not shared with any immigration authorities.
What other health insurance coverage should immigrants consider?
Immigrants unable to receive ACA coverage may consider short-term health insurance coverage a viable option, as it's far better than being uninsured. Short-term health coverage plans are not sold through the Marketplace, so they are not beholden to the exchange requirements that enrollees provide proof of legal residency.
While short-term health coverage plans are not beholden to some of the enrollment requirements of ACA coverage, they also are not required to provide the guarantees that ACA coverage offers. Some short-term health coverage may also not provide any coverage for pre-existing conditions. Still, for healthy applicants who qualify for short-term health coverage, a short-term plan is far better than no coverage.
As with any insurance plan, it is crucial to either have a good agent who will guide you through the process of picking a plan and have your best interest at heart or read the fine print, so you know and understand the ins and outs of the coverage. That rule is essential with short-term health coverage plans as the federal government loosely regulates them. Though some states have placed extensive regulations for short-term health plans, availability may vary from one state to another.
Another insurance similar to short-term health plans is Travel Insurance. Travel insurance, in particular, is for people who will be in the United States temporarily and do not qualify for ACA coverage. This is because, much like short-term health coverage, their policies do not need to comply with the ACA, tend to have gaps in the coverage, and may limit how much they'll pay for the enrollee's medical care.