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Tag: medicaid

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:

Can family members in families with mixed immigration status, where some family members are citizens or lawfully present and others are undocumented, enroll in Medicaid or CHIP or receive help buying coverage through the Marketplaces?

Citizen and lawfully present family members can get health insurance coverage through Medicaid, CHIP, and Marketplaces even if other family members are not lawfully present. Family members who are not lawfully present, including undocumented immigrants, may apply for health insurance for citizen and lawfully present family members. For example, an undocumented immigrant parent may apply for health insurance for a citizen child.

When a family with mixed immigration status applies for health insurance, it only has to give citizenship and immigration status for those family members applying for coverage. Non-applicants, such as a parent applying for a child, do not have to provide citizenship or immigration status. Non-applicants will be asked to provide a Social Security Number, but do not have to provide one unless the family is applying for help with costs for Marketplace coverage and the individual is the tax-filer for the household, and the individual has a SSN.  Information provided by applicants will not be used for immigration enforcement purposes.

Can immigrants enroll in Medicaid or Children’s Health Insurance Program (CHIP) coverage?

Most lawfully present immigrants who meet Medicaid and CHIP program requirements, such as income and state residency, can enroll in Medicaid or CHIP after they have been in the United States for 5 years or more.

Some groups of lawfully present immigrants do not have to wait five years before they may enroll in Medicaid and CHIP. These include refugees, asylees, and other humanitarian immigrants; veterans and military families; and pregnant women and children in some states.

Some lawfully present immigrants who are authorized to work in the United States cannot enroll in Medicaid, even if they have been in the country for five or more years.

Undocumented immigrants may not enroll in Medicaid or CHIP coverage.

I live in a state that has chosen not to expand Medicaid. When I applied for Marketplace coverage, my income was just above the poverty level, so I applied for and received an advance premium tax credit. What happens if I lose my job toward the end of the year so my annual income will be just under the poverty level? Will I have to pay back the advanced subsidies I’ve received?

No.  If you were determined eligible for subsidies when you signed up, and your income turns out to be lower, you will not have to repay the subsidies you received.

I’m low income and enrolled in subsidized Marketplace coverage now. I just found out I’m pregnant. Under my state’s rules, I now qualify for Medicaid. Do I have to drop out of the Marketplace coverage and enroll in Medicaid? If I don’t will I have to pay back the premium tax credit subsidy?

In nearly all states, pregnancy-related Medicaid provides the same (or similar) benefits as Medicaid for other adults and so is considered minimum essential coverage (MEC).  (In 3 states – Arkansas, Idaho, and South Dakota – pregnancy-related Medicaid only covers maternity care and is not recognized as MEC).  The general rule requires that people eligible for other MEC are not eligible for premium tax credits.  However, a special rule allows women who are already receiving APTC and who become pregnant and eligible for pregnancy-related Medicaid to choose whether to stay in their marketplace plan with APTC or enroll in the pregnancy-related Medicaid.   For example, women might choose pregnancy-related Medicaid because it does not charge monthly premiums or cost sharing for covered services.

If you decide to enroll in the pregnancy-related Medicaid (in all but 3 states), you will no longer be eligible for APTC while you are enrolled in Medicaid.    If you decide to enroll in the pregnancy-related Medicaid and live in one of 3 states offering limited benefits, you can apply for an exemption from the individual mandate and won’t owe a penalty for lacking MEC coverage during those months.  In all states, when your pregnancy and pregnancy-related Medicaid ends, you will be eligible for a special enrollment period (SEP) and can sign up for marketplace coverage and APTC at that time.

But if you prefer to stay in your marketplace plan you can continue receiving APTC and won’t be required to pay it back later just because you were eligible for pregnancy-related Medicaid.

I estimate my income next year will be 140% of the federal poverty level, so I need a premium tax credit and I need to have it all paid in advance. If, by the end of the year, it turns out my annual income was even lower – 130% of the federal poverty level – so I could have enrolled in Medicaid, will I have to pay back the premium subsidy?

No, your final premium credit amount will be determined based on your income for the year as reported on your tax return. The fact that it ended up being 130% of the poverty line does not mean you have to pay back the premium tax credit you received. In fact, your final credit amount will likely be larger than the amount you received in advance.