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Author: Hummingbird Insurance

Am I required to have health insurance?

Congress eliminated the federal tax penalty for not having health insurance, effective January 1, 2019.

For 2018, most people are required to have health insurance or else pay a tax penalty, unless they qualify for an exemption.  This is called the individual responsibility requirement, or the individual mandate.

While the federal tax penalty continues to apply for 2018, recent changes will make it easier for people to claim a hardship exemption, and so owe no penalty, when they file their 2018 federal income tax return.  If you experienced a hardship that prevented you from getting coverage in 2018, just check the box on the front of Form 1040, indicating that you qualify for a hardship exemption.  You will not be required to submit proof of the hardship with your tax return, though you should retain any documentation for your own records.

Several states have adopted individual mandates with state tax penalties for not having health insurance.  These include Massachusetts, New Jersey, and the District of Columbia, effective for the 2019 calendar year.  Vermont will impose a tax penalty for not having health insurance starting in 2020.  Other states are considering state individual mandates.  Check with your tax adviser for more information.

Regardless of the penalty, it is important to have health coverage if you can.  Health insurance continues to be offered during annual Open Enrollment periods.  If you don’t sign up during Open Enrollment you might have to wait up to one year until your next opportunity to enroll.

I entered the U.S. lawfully and I’m over 65, but I don’t qualify for Medicare. Can I apply for coverage and subsidies in the Marketplace? I hear premiums can be higher based on age. How much higher can my premium be if I’m over age 65?

Yes, you can purchase Marketplace coverage and qualify for subsidies based on your income. Premiums for Marketplace plans can vary by age unless States decide otherwise. In most states, your premium (before taking into account tax credits) could be up to three times that charged for somebody in their early 20s. Several states prohibit age adjustments to premiums or require lower age adjustments.

Where can immigrants get health care or health coverage when they cannot enroll in Medicaid or CHIP or get coverage through the Marketplaces?

Hospitals are required to provide emergency care and treatment to all individuals regardless of immigration or insurance status, though afterwards they can bill for their services. In addition, individuals may get low-cost care at community health centers.

Individuals may purchase health coverage through an employer or a spouse’s employer or the individual insurance market outside of the Marketplace. Some states and counties also offer health programs for immigrants.

Are individuals granted deferred action under “Deferred Action for Childhood Arrivals” eligible for Medicaid, CHIP, and the Health Insurance Marketplaces?

Some undocumented youth have been given temporary permission to stay in the United States under a program called Deferred Action for Childhood Arrivals. These individuals are lawfully present in the United States and can be granted work authorization and Social Security numbers. However, they are not eligible for Medicaid, CHIP, or the Marketplaces.

Who is a lawfully present immigrant for health insurance purposes?

Lawfully present immigrants generally include:

  • lawful permanent residents (or “green card holders”);
  • persons fleeing persecution, including refugees and asylees;
  • other humanitarian immigrants, including those granted temporary protected status;
  • Cuban/Haitian entrants; and
  • survivors of domestic violence, trafficking, and other serious crimes.

Are immigrants required to have health insurance coverage under the Affordable Care Act’s individual mandate?

Most immigrants who are residents lawfully present in the U.S., including “green card holders,” are subject to the ACA’s individual mandate.

However, for 2018, people who lack coverage during the year can claim an exemption from the tax penalty directly on their tax return if they experienced circumstances that prevented them from obtaining coverage.  No documentation of the hardship is required to be submitted with the tax return, though taxpayers should retain all documentation for their files.

Starting in 2019, there will be no tax penalty for failing to have health insurance coverage.

Immigrants who are not lawfully present in the U.S. will not pay a tax penalty if they do not have health insurance.

Will getting health insurance through Medicaid, CHIP, or Health Insurance Marketplaces affect an individual’s ability to obtain lawful permanent resident status or citizenship?

Currently, getting health insurance through Medicaid, CHIP, or the Marketplaces generally will not prevent an individual from obtaining lawful permanent resident status (get a green card) or citizenship.  One exception would be if an individual is receiving long-term care in an institution that is financed by Medicaid.

The rules may change for people seeking a green card in the future, but those changes are not yet final.  If you are living in the U.S. and applying for a green card here, you can still get health insurance through Medicaid, CHIP, or a Health Insurance Marketplace without affecting your application.  Get help deciding what is best for your family and consult with an immigration attorney if you can.  You can use this online directory to search for local nonprofit organizations that provide legal help and advice:  http://www.immigrationlawhelp.org

How will an individual’s citizenship and immigration status be checked?

Only those individuals in a family who are applying for health insurance are required to provide citizenship and immigration status. Applicants also must provide a Social Security Number if they have one.  Information provided by applicants will not be used for immigration enforcement.

Citizenship and immigration status for those applying for health insurance will be checked electronically with several systems, including the Social Security Administration, the Department of Homeland Security, and SAVE (Systematic Alien Verification for Entitlements).

If an individual’s status cannot be checked through an electronic match, the individual can give other documentation of his or her status.