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Yes. All lawfully-present immigrants – including “nonimmigrants” like H-2A workers and those on student visas – may purchase insurance in the Marketplace. Those who are low-income and otherwise eligible may also receive premium assistance and cost-sharing reductions to lower the cost of coverage in Marketplace plans.
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Eligibility to buy coverage in the Marketplace is based on where you establish your permanent residence. Some health insurers will offer larger networks than other plans and may offer regional or national provider networks. Once Open Enrollment begins, check the plans available in your Marketplace to see if there is a plan with provider coverage in the areas you work. If your move during the year is a permanent move, not just a temporary one, you may qualify for a special enrollment period following the permanent move.
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If you’re a full-time worker and work for a large employer, your employer will face a penalty if they don’t provide coverage. Some employers may opt to take the penalty and not offer coverage. Check with your employer to see what they offer.
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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.
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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.
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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.
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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.
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Lawfully present immigrants generally include:
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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.
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Medicaid, CHIP, and the Marketplaces must protect individuals’ information and keep it private. Information can be used only for eligibility and enrollment purposes. Information provided by applicants will not be used for immigration enforcement purposes.