Open Enrollment Series:
September 2023

Part I: Immigration-Related Eligibility for Health Coverage Programs

In this Beyond the Basics webinar presented in partnership with the National Immigration Law Center (NILC) on September 19, 2023, Gabrielle Lessard, Senior Policy Attorney at NILC, and Shelby Gonzales, Vice President for Immigration Policy at the Center on Budget and Policy Priorities, provide an overview of immigration-related eligibility requirements for Medicaid, the Children’s Health Insurance Program, and coverage through the Affordable Care Act marketplaces. This is the first of two webinars in this year’s series focused on enrollment issues for people who are immigrants.

Note: In May 2024, the Department of Health and Human Services finalized a rule that will newly allow people with Deferred Action for Childhood Arrivals (DACA) and people with certain other immigration statuses to enroll in ACA marketplace coverage beginning November 1, 2024. We will update this resource to reflect those changes when the new policy is in place

Webinar Resources

↓ Presentation Slides (PDF)

Open Enrollment Series

Jump To:

Immigration-Related Eligibility for Health Coverage Programs

  • Insurance Affordability Programs’ Immigration-Related Eligibility Standards
  • Medicaid & CHIP Use “Qualified” Immigrant Eligibility Standard
  • Many People Are Barred from Medicaid & CHIP for 5 Years
  • States Have Flexibility to Vary from Federal Eligibility Rules
  • The ACA Marketplace Uses the Lawfully Present/Residing Standard for Enrollment Eligibility
  • New Proposed Changes to Eligibility Based on Immigration Status

Eligibility for Health Coverage Programs Based on Immigration Status

  • Examples

Other Important Eligibility Rules for Families that Include Immigrants

  • Special PTC Rule
  • Examples
  • Special Marketplace Rules for Older Adults
  • State Residency for Marketplace, Medicaid, & CHIP
  • PTC-Related Rules for Married People Who Have Nonresident Status

Options for People Ineligible for Insurance Affordability Programs Due to Immigration Status

  • People Who Don’t Meet Immigration-Related Requirements
  • People Who Do Not Meet the Immigration-Related Requirements for Medicaid, CHIP or Marketplace
  • Medicaid Payment for Emergency Services
  • Programs That Don’t Restrict Eligibility Based on Status

Additional Resources

Reference Guide: Documents Used to Verify Immigration Status

Key Facts:

National Immigration Law Center (NILC) Resources:

Protecting Immigrant Families Resource:

Healthcare.gov Marketplace Resources: 

Health Reform: Beyond the Basics is a project of the Center on Budget and Policy Priorities designed to provide training and resources that explain health coverage available through Medicaid, CHIP, and the Marketplace. It is aimed at navigators, advocates, state and local officials and others who help consumers get and keep their health coverage.

Stay up to date:

Center on Budget and Policy Priorities

1275 First Street NE, Suite 1200
Washington, DC 20002

Beyondthebasics@cbpp.org

Robert Wood Johnson Foundation

Support for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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