I am reproducing below
article from Healthcare.gov, which I thought gave a good insight on how the
Federal Affordable Care Act impacts immigrants.
Another more specific article detailing covered legal statuses and the
documentation is also incorporated herein. The Open enrollment for Marketplace coverage
ends March 31, 2014. The next proposed open enrollment period is November 15,
2014 - January 15, 2015.
Lawfully present immigrants and private insurance
In order to buy private health insurance through the
Marketplace, you must be a U.S. citizen or be lawfully present in the United
States. The term “lawfully present” includes immigrants who have:
•
“Qualified non-citizen” immigration status without a waiting
period
•
Humanitarian statuses or circumstances (including Temporary
Protected Status, Special Juvenile Status, asylum applicants, Convention
Against Torture, victims of trafficking)
•
Valid non-immigrant visas
•
Legal status conferred by other laws (temporary resident status,
LIFE Act, Family Unity individuals)
Lawfully present immigrants and lower costs
If you’re a lawfully present immigrant, you can buy private
health insurance on the Marketplace. You may be eligible for lower costs on
monthly premiums and lower out-of-pocket costs based on your income.
•
If your annual income is 400% of the federal poverty level or
below:
Lawfully present immigrants with estimated 2014 household incomes up to 400% of
the federal poverty level (about $45,960 for an individual or
$94,200 for a family of 4) may be eligible for tax credits that can be used
immediately to reduce monthly premiums for insurance bought in the Marketplace.
•
If your annual household income is below 100% federal poverty
level:
Lawfully present immigrants with estimated 2014 household income under 100% of
the federal poverty level (about $11,490 for an individual or $23,550 for a
family of 4), who are not otherwise eligible for Medicaid, will be eligible for
tax credits and lower out-of-pocket costs for private insurance through the
Marketplace if they meet all other eligibility requirements.
Immigrant access to Medicaid and CHIP
Immigrants who are “qualified non-citizens” are generally
eligible for Medicaid and Children’s Health Insurance Program (CHIP) coverage,
if they are otherwise eligible for Medicaid and CHIP in the state (in other
words, if they meet their state’s income eligibility rules).
The term “qualified non-citizen” includes:
•
Lawful Permanent Residents (LPR/Green Card Holder)
•
Asylees
•
Refugees
•
Cuban/Haitian entrants
•
Paroled into the U.S. for at least one year
•
Conditional entrant granted before 1980
•
Battered non-citizens, spouses, children, or parents
•
Victims of trafficking and his or her spouse, child, sibling, or
parent or individuals with a pending application for a victim of trafficking
visa
•
Granted withholding of deportation
•
Member of a federally recognized Indian tribe or American Indian
born in Canada
In order to get Medicaid and CHIP coverage, under current law
most LPRs or green card holders have a 5-year waiting period. This means they
must wait 5 years after receiving “qualified” immigration status before being
eligible for Medicaid and CHIP. There are also exceptions -- LPRs who don’t
have to wait 5 years -- such as people who used to be refugees or asylees.
States may remove the 5-year waiting period and cover lawfully
residing children and/or pregnant women who are otherwise eligible for
Medicaid. A child or pregnant woman is “lawfully residing” if lawfully present
and otherwise eligible for Medicaid or CHIP in the state (including being a
state resident).
This option to provide Medicaid coverage to lawfully residing
children and/or pregnant women without a 5-year waiting period is already in
effect in 25 states, plus the District of Columbia and the Commonwealth of the
Northern Mariana Islands. Twenty of these states have chosen to cover lawfully
residing children or pregnant women in CHIP. Find out if your state has this option in place.
People who don’t have eligible immigration status and therefore aren’t eligible
for Medicaid may get Medicaid coverage for limited emergency services, if they
meet all other Medicaid eligibility criteria in the state.
Applying for Medicaid or CHIP, or getting help with health
insurance costs in the Marketplace, does not make someone a “public charge.” It will not affect someone’s
chances of becoming a Lawful Permanent Resident or U.S. citizen. The one
exception is for people receiving long-term care in an institution at
government expense. These people may face barriers getting a green card.
Mixed status families’ options for care and coverage
Many immigrant families are of “mixed status,” with members
having different immigration and citizenship statuses. Some families may have
taxpaying members who can’t buy health insurance through the Marketplace,
alongside other family members who are eligible to use the Marketplace as
citizens or lawfully present immigrants.
The same situation could apply in a family that has some members
who are not eligible for full Medicaid, and others who are eligible for
Medicaid or CHIP.
“Mixed status” families can apply for a tax credit or lower
out-of-pocket costs for private insurance for their dependent family members
who are eligible for coverage in the Marketplace or for Medicaid and CHIP
coverage. Family members who aren't applying for health coverage for themselves
won't be asked if they have eligible immigration status.
Disclosure of immigration status
Federal and state Marketplaces and state Medicaid and CHIP
agencies can’t require applicants to provide information about the citizenship
or immigration status of any family or household members who are not applying
for coverage. States also can’t deny benefits to an applicant because a family
or household member who isn't applying hasn’t disclosed his or her citizenship
or immigration status.
Generally, Health Insurance Marketplaces and state Medicaid and
CHIP agencies can require the disclosure of Social Security Numbers (SSNs) only
for applicants, recipients of benefits, and certain people whose income is
needed for computing tax credits.
States can ask other non-applicants for an SSN but only if they
clearly indicate that providing this information is voluntary, and if they
explain how the information will be used. States can’t deny benefits because
the applicant doesn’t provide the SSNs of people who aren’t applicants for
benefits or recipients of Medicaid or CHIP benefits, or those not required to
provide SSNs.
Federal and state Marketplaces and state Medicaid and CHIP
agencies verify application information through a “data services hub.” The hub
allows the Marketplace and Medicaid and CHIP to securely submit application
information. The federal government sends information back to verify the data.
The Department of Health and Human Services and other federal
agencies apply privacy and security standards to govern the use and transfer of
this information. Applications for the Marketplace and Medicaid and CHIP ask
only for the information needed to determine eligibility for health coverage.
People who aren’t seeking coverage for themselves won’t be asked about their
immigration status.
Information provided by applicants or beneficiaries won’t be
used for immigration enforcement purposes.
Additional information for immigrant families
Federally-funded health centers, which are community-based
organizations that serve populations with limited access to health care, are
required to provide primary health care services to all residents, including
immigrant families, in the health center’s service area.
States may choose to provide insurance coverage to additional
immigrant populations. About one-third of states offer health coverage using
state-only funds to other non-citizens who don’t meet federal definitions.
Undocumented immigrants aren’t eligible for federal public
benefits through the Affordable Care Act. For example, undocumented immigrants
can’t buy coverage through the Marketplace. Premium tax credits aren’t
available for undocumented immigrants.
Undocumented
immigrants may continue to buy coverage on their own outside the Marketplace
and can get limited services for an emergency medical condition through
Medicaid, if they are otherwise eligible for Medicaid in the state.
Undocumented immigrants aren’t subject to the individual shared responsibility
requirement.
____________________
Following is a list of immigration statuses that qualify for
Marketplace coverage.
•
Lawful Permanent Resident (LPR/Green Card holder)
•
Asylee
•
Refugee
•
Cuban/Haitian Entrant
•
Paroled into the U.S.
•
Conditional Entrant Granted before 1980
•
Battered Spouse, Child and Parent
•
Victim of Trafficking and his/her Spouse, Child, Sibling or
Parent
•
Granted Withholding of Deportation or Withholding of Removal,
under the immigration laws or under the Convention against Torture (CAT)
•
Individual with Non-immigrant Status (includes worker visas,
student visas, and citizens of Micronesia, the Marshall Islands, and Palau)
•
Temporary Protected Status (TPS)
•
Deferred Enforced Departure (DED)
•
Deferred Action Status (Deferred Action for Childhood Arrivals
(DACA) is not an eligible immigration status for applying for health insurance)
•
Lawful Temporary Resident
•
Administrative order staying removal issued by the Department of
Homeland Security
•
Member of a federally-recognized Indian tribe or American Indian
Born in Canada
•
Resident of American Samoa
Applicant for any of these statuses:
•
Temporary Protected Status with Employment Authorization
•
Special Immigrant Juvenile Status
•
Victim of Trafficking Visa
•
Adjustment to LPR Status
•
Asylum*
•
Withholding of Deportation or Withholding of Removal, under the
immigration laws or under the Convention against Torture (CAT)*
*Only those who have been granted employment authorization or
are under the age of 14 and have had an application pending for at least 180
days are eligible
With Employment Authorization:
•
Registry Applicants
•
Order of Supervision
•
Applicant for Cancellation of Removal or Suspension of
Deportation
•
Applicant for Legalization under IRCA
•
Legalization under the LIFE Act
Documentation
To
support Marketplace applications, the following documents may be required or
used, depending on the individual situation:
•
Permanent Resident Card, “Green Card” (I-551)
•
Reentry Permit (I-327)
•
Refugee Travel Document (I-571)
•
Employment Authorization Card (I-766)
•
Machine Readable Immigrant Visa (with temporary I-551 language)
•
Temporary I-551 Stamp (on passport or I-94/I-94A)
•
Arrival/Departure Record (I-94/I-94A)
•
Arrival/Departure Record in foreign passport (I-94)
•
Foreign Passport
•
Certificate of Eligibility for Nonimmigrant Student Status
(I-20)
•
Certificate of Eligibility for Exchange Visitor Status (DS2019)
•
Notice of Action (I-797)
•
Document indicating membership in a federally recognized Indian
tribe or American Indian born in Canada
•
Certification from U.S. Department of Health and Human Services
(HHS) Office of Refugee Resettlement (ORR)
•
Office of Refugee Resettlement (ORR) eligibility letter (if
under 18)
•
Document indicating withholding of removal
•
Administrative order staying removal issued by the Department of
Homeland Security
Alien number or 1-94 number
Source:
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