ACA Gives Legal Immigrants New Opportunities

SPHHS report suggests new law may help 6 million legal immigrants obtain health coverage.

December 18, 2013

Medicine Healthcare

The Affordable Care Act (ACA) does not expand access to health insurance for undocumented immigrants but may pave the way for many legal immigrants who have trouble obtaining this crucial coverage,  concludes a new report from the George Washington University School of Public Health and Health Services (SPHHS).

“Strengthening Immigrants’ Health Access: Current Opportunities” outlines the opportunities as well as the obligations that the federal health reform law will bring to lawfully present immigrantspeople who have obtained green cards or visas allowing them to work, live and study in the United States.

“Most people do not realize that legal immigrants currently face many obstacles to obtaining health insurance,” said Leighton Ku, the author of the new report and director of the Center for Health Policy Research at SPHHS. “Such immigrants are three times as likely to be uninsured as those born in the United States.”

Without health coverage, they—like other uninsured Americans—often delay or never get potentially life-saving health care, he said.

This issue brief, which was funded by the Commonwealth Fund, notes that the federal health reform law might help as many as 6 million “lawfully present” immigrants either find affordable health insurance through health insurance exchanges or enroll in Medicaid. The issue brief outlines two main benefits for legal immigrants under the health reform law.

First, legal immigrants who do not have health insurance will be able to sign up for coverage through the new exchangesonline marketplaces where people can shop for a health plan. Depending on their income and other factors, legal immigrants may be able to qualify for federal tax credits that will make a health plan more affordable, said Dr. Ku.

Second, many lawfully present immigrants also will become eligible for Medicaid under the ACA reforms. Under a Supreme Court ruling on the ACA, states can open up Medicaid programs to cover many more low-income adults. To date, about half the states have opted to expand their Medicaid programs. Legal immigrants living in the expanding states might find they qualify for Medicaid coverage if they meet income and other requirements, according to the report.

Under the ACA, the new health coverage benefits will not begin until January 2014, but the analysis notes that legally present immigrants can log onto a health insurance exchange, either one run by a state or by the federal government, to look at their options and shop for coverage now.

The issue brief also notes that many low-income immigrants speak a language other than English and may have no easy way to access the Internet. Dr. Ku said many states have put in place community-based navigators that can translate the details of a health plan or the cost-sharing obligations from English into another language. Such navigators can help lower-income legal immigrants sign up for a plan or gain access to Medicaid coverage if they are eligible.