Undocumented immigrants face many barriers to health care access, including cost and fear of immigration authorities. Following the Supreme Court’s ruling on DAPA/DACA, undocumented immigrants remain without comprehensive coverage options.
New York provides access to health coverage through state funds for undocumented residents who qualify. Governor Kathy Hochul has taken an important step toward fulfilling her promise, sending a letter to federal health officials seeking guidance on using federal healthcare dollars for expanding options available to all.
1. Employer-Sponsored Coverage
Undocumented immigrants don’t qualify to purchase private health insurance through the Affordable Care Act Marketplace (Obamacare), although coverage may be available through their employers or as dependents of legal citizens and permanent residents.
Undocumented immigrants can access low-cost health care through community health clinics. These nonprofit organizations typically charge on a sliding fee scale, such as Planned Parenthood or federally qualified health centers.
However, some colleges provide student health plans regardless of immigration status – providing young adults an option that avoids the higher costs associated with purchasing health care on an individual market.
Finally, many states provide Medicaid coverage to low-income people such as children, pregnant women and those living with serious or chronic health conditions. Some states, including California, Illinois, Massachusetts, New York, Oregon and Washington have expanded eligibility to cover all low-income people; California is considered “blue,” where Democratic lawmakers have advocated to expand access.
2. Private Plans
Undocumented immigrants looking for affordable healthcare coverage can turn to private health insurance plans as one source. Employers or themselves may offer these policies; the insurer will not inquire into their immigration status nor report to healthcare providers any concerns that they might have.
Undocumented immigrants do not qualify for federal programs like Medicare and Medicaid; however, they still spend significant sums on healthcare within the U.S. while contributing significantly more in taxes than they receive back.
Some states are creating programs using state funds to subsidize health insurance for undocumented immigrants, often at more expensive premiums than those available through an ACA-compliant exchange plan. Other states are expanding Medicaid eligibility so all eligible undocumented residents may access it, while still other states consider permitting undocumented residents to access the marketplace even though they do not qualify for premium subsidies.
3. Medicaid
Many states provide undocumented immigrants a way to access affordable healthcare without having to buy private insurance policies. State Medicaid programs can offer low-cost primary and preventive healthcare to residents who meet income eligibility requirements – this may include undocumented residents. Preventive measures may help mitigate chronic diseases that may save on healthcare costs in the long run.
Immigration status should never be disclosed when applying for marketplace or Medicaid coverage; even DACA recipients do not qualify for marketplace subsidies (or Medicare).
However, some states are seeking federal permission to allow undocumented individuals to enroll in their own state-based exchanges beginning in 2023. Colorado allows undocumented people to purchase private coverage through its program with state subsidies; and several colleges and universities offer health plans open to students regardless of immigration status – this move is one step toward guaranteeing everyone has access to affordable healthcare coverage.
4. Care Membership Plans
Many states have implemented programs to assist undocumented residents obtain affordable healthcare. These non-government-sponsored health plans, commonly known as safety net coverage plans, offer low cost coverage while waiting for immigration status approval – examples being California’s County Medical Services Program and Massachusetts’ Health Safety Net respectively.
Some state lawmakers remain wary of expanding coverage options for undocumented residents, fearing this could create an influx of individuals that could strain budgets and health care infrastructure in their states.
However, in certain states a new form of coverage has emerged: community health clinics. These low-cost health insurance plans, not sponsored by any governing entity such as government exchanges or Medicaid, offer basic medical coverage at a monthly fee – making them an attractive option for undocumented immigrants who can’t afford more costly ACA-compliant plans or are ineligible. For more information and locations of free clinics near you see this national free clinic directory or this state specific list of free clinics.
