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Barriers to Immigrants’ Access to Health Insurance and Health Care. Legal barriers - http://nilc.org/access-to-bens.html

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barriers to immigrants access to health insurance and health care
Barriers to Immigrants’ Access to Health Insurance and Health Care
  • Legal barriers - http://nilc.org/access-to-bens.html
  • Confusion around eligibility rules -http://nilc.org/immigrantshcr.html; http://nilc.org/immigrantshcrsp.html; https://www.healthcare.gov/what-do-immigrant-families-need-to-know/
  • Public charge - http://nilc.org/pubcharge.html
  • Sponsor deeming and liability - http://nilc.org/affidavits.html
  • Verification & documentation - http://nilc.org/document.html?id=35; https://www.healthcare.gov/help/immigration-document-types/; https://www.healthcare.gov/help/citizenship-and-immigration-status-questions/
  • Confidentiality and reporting fears - http://www.ice.gov/doclib/ero-outreach/pdf/ice-aca-memo.pdf
  • Linguistic and cultural barriers - https://www.cuidadodesalud.gov/es/; http://marketplace.cms.gov/getofficialresources/other-languages/other-languages-materials.html; http://www.hhs.gov/open/execorders/13166/index.html
  • Fear of immigration enforcement - http://www.ice.gov/doclib/ero-outreach/pdf/ice-aca-memo.pdf
  • Residency and other program requirements
who s eligible for federal non emergency medicaid and chip
Who’s Eligible for Federal Non-emergency Medicaid and CHIP?

Two categories of immigrants for federal benefits eligibility purposes under “welfare reform” (PRWORA of 1996):

  • ELIGIBLE = “Qualified”: Categories defined by statute –
    • LPRs, refugees, asylees, parolees, Cuban/Haitian entrants, certain DV and trafficking survivors and their derivatives, certain conditional entrants
    • Qualified immigrants who entered the U.S. on or after August 22, 1996 must wait at least five years in qualified status (also known as the “five-year bar”)
    • Some exemptions
  • NOT ELIGIBLE = “Not qualified”: Anyone who is not a citizen or “qualified” immigrant, such as—
    • Undocumented immigrants
    • PRUCOLs (other lawfully present individuals)
    • Temporary visa holders
exceptions in medicaid and chip
Exceptions in Medicaid and CHIP
  • In 2002 HHS granted states the option to provide prenatal services to pregnant women under the “unborn child” option in CHIP.
    • See NILC coverage maps at http://www.nilc.org/healthcoveragemaps.html
  • CHIPRA of 2009 granted states the option to provide Medicaid/CHIP to “lawfully present” children and pregnant women and waive the 5-yr bar -http://nilc.org/facts-chipra.html
  • State variation - http://www.nilc.org/document.html?id=159
  • Medicaid for treatment of emergencies available if not eligible for Medicaid based on immigration status
    • Emergency Medicaid expands as Medicaid expands, with full FMAP - http://www.medicaid.gov/Federal-Policy-Guidance/downloads/FAQ-12-27-13-FMAP-Foster-Care-CHIP.pdf (Q #5)
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Health Coverage for Pregnant Women | January 2014

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Health Coverage for Immigrant Children | January 2014

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immigrants and the aca
Immigrants and the ACA

“Lawfully Present” Individuals

  • On road to citizenship (e.g., Lawful Permanent Resident (LPR))
  • Permission to stay indefinitely in the U.S. without pathway to citizenship (e.g., TPS)
  • Permission to stay temporarily (e.g., visa holders)
    • Exception: DACAmented individuals http://www.nilc.org/acadacafaq.html
  • See https://www.healthcare.gov/immigration-status-and-the-marketplace/

Undocumented

    • Individuals who lost permission to remain in the U.S., or entered the U.S. without permission

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  • Emergency Medicaid
  • No Marketplace/Exchange access
  • No ACA subsidies
  • Exempt from individual mandate
  • Remain eligible for FQHCs and other programs available regardless of status