FAQ about immigration status and the new healthcare law

In 2010, the United States Congress passed the Affordable Care Act (also known as the ACA or Obamacare), expanding health insurance for individuals in the United States. This FAQ addresses questions about how the ACA affects people in different immigration statuses. This post is intended as a general overview of the ACA; if you have specific questions about Cover Oregon or another state’s plan, we recommend visiting the Cover Oregon website or the website for your state of residence and speaking with one of their specialists.

Q: Who qualifies for “Marketplace coverage” (i.e. who can buy health insurance using the ACA website)?

A: U.S. citizens and all individuals who have been legally present in the U.S. for five years or more are eligible. You may also qualify for Medicaid.

People who have been lawfully present for less than five years also qualify for “Marketplace coverage,” but do not qualify for Medicaid. Also, individuals who are applicants for certain statuses, such as asylum, SIJS, and cancellation of removal also are eligible, although it may depend on whether this person has employment authorization. A full list of people who are eligible is available on the government’s website. There are other restrictions to qualify for Marketplace coverage, including income. Details are available at this link.

There are also special programs for people who do not have status or who otherwise do not qualify for ACA healthcare. We recommend looking at Cover Oregon’s website and speaking with one of their specialists if you have any doubts.

Q: Who is required to have health insurance (i.e. who is subject to the health insurance “mandate”)?

A: The ACA requires that all individuals who are legally present in the U.S. have health insurance. This includes legal permanent residents, and people who are present under a U-visa, T-visa, VAWA, asylum/refugee status, Temporary Protected Status (TPS) or a beneficiary of one of these statuses. It does not include people who are undocumented or who have deferred action status under DACA (but does include those who were given deferred action status by a judge).

Q: What happens if I am lawfully present in the U.S. but do not have health insurance?

A: There is a fee penalty for lawfully present individuals without health insurance. You will have to pay the government. The penalty will be phased-in according to the following schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014, 2.0% of taxable income in 2015, and 2.5% of taxable income in 2016.

Q: Are there exceptions to the requirement that all lawfully present individuals have health insurance?

A: Yes, exemptions exist for financial hardship, religious objections, American Indians, those without coverage for less than three months, undocumented immigrants, incarcerated individuals, and people with low incomes (people for whom the lowest cost plan option is more than 8% of their income and people with incomes below the tax filing threshold).

Q: Should I worry about being considered a “public charge” or other negative effects on my immigration case if I accept benefits under the ACA?

A: No, taking an insurance subsidy under the ACA is not considered and will not hurt your immigration case or chance at a green card.

Q: What if I have deferred action status under DACA?

A: Individuals present in the US under DACA do not qualify for subsidized coverage and cannot buy health insurance on the market exchange. They are also not subject to any penalties if they do not have health insurance.

Q: What if I am undocumented?

A: Individuals present in the U.S. without lawful status do not qualify for subsidized coverage and are not subject to any penalties if they do not have health insurance. So you cannot buy health insurance in the market exchange, but you do not have to pay a penalty for not having health insurance.