How does the Affordable Care Act affect immigrants?


    Question: How does the Affordable Care Act affect immigrants?

    Got questions about the Affordable Care Act? In a regular feature, the WHYY/NewsWorks Health and Science Desk is providing “The Short Answer.”

    Today’s question

    How does the Affordable Care Act affect immigrants?

    The short answer

    The short answer is it depends on a person’s immigration status. For people living in the country legally — that’s naturalized citizens, immigrants who are granted permission to live and work in the U.S. — the Affordable Care Act provides more coverage options and assistance, similar to what it does for everyone else. One study estimates that immigrants, in general, are two and a half times more likely to be uninsured, so that can have some big implications.

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    Will these online marketplaces, which open soon, work any differently for immigrants?

    Nothing’s really different for lawfully present immigrants. They’ll be able to get coverage through the marketplaces, and they’ll also be eligible right away for those income-based subsidies to buy coverage. Typically, there’s a waiting period for eligible immigrants to get public health benefits, like Medicaid. It’s about five years. But for getting coverage through these new marketplaces and getting subsidies to help pay for it, that all kicks in right away. Of course, the flip side is they’re also subject to the same penalties as everyone else for not having coverage.

    We know there are some families out there that are of mixed immigration status, what does the law say about them?

    So let’s say you’re in the country lawfully, but your parents are not. You’d be eligible for coverage, but they would not (a parent or guardian won’t be asked about their own immigration status, however, when enrolling their eligible children for coverage).

    People living in the country unlawfully are not eligible for coverage on the new marketplaces, either. They’re not eligible for the subsidies, and they’re barred from getting coverage even if they wanted to totally pay for it themselves. They’re also ineligible for other public coverage options, like Medicaid, with some exceptions for emergencies. Additionally, immigrant youth who came to the country as children and were recently granted deferred action are excluded from coverage.

    Now community health clinics are often known as places that provide care to everyone, and the law is actually giving them a big funding boost.

    How about the languages that everyone’s speaking?

    The law requires that “linguistically appropriate services” be available to people who speak another language. Mara Youdelman, managing attorney at the National Health Law Program, says that may be a challenge as insurers, doctors, and even call centers are expected to have some plan in place for providing language services.

    “One out of every four marketplace applicants is expected to speak a language other than English at home,” Youdelman says. “The ACA and preexisting civil rights laws require that limited English proficient consumers can apply for and access health insurance.”

    In the federally run marketplaces, like in Pennsylvania and New Jersey, the application for coverage will be in English and Spanish. There are expected to be tools in about 30 other languages for understanding the process.

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