Affordable Care Act affects immigrants, too

California has more immigrants than any other state. At least one in four Californians -- more than 10 million people -- were born in another country.

And they're a diverse bunch: Some immigrants, such as my parents, are naturalized U.S. citizens.


Lots of you have asked how the Affordable Care Act, or better known as Obamacare, affects immigrants. How I'd love to hand you a one-size-fits-all response. But this is the Affordable Care Act, after all, and the law treats categories of immigrants differently.

Q What types of immigration status will be covered under Obamacare?

A Let's start with one important little detail: All naturalized citizens and legal immigrants must have health insurance as of Jan. 1 or pay a tax penalty. (That is, unless they fit into a category of people who are exempt, including those who cannot find "affordable" coverage, as defined by the law.)

The insurance requirement isn't as ironclad for people with temporary visas. Some will have to abide and some won't. (Thanks Obamacare!) If you're not sure where you fall, check with an immigration attorney.

Whether you're eligible for zero, some, or all Obamacare programs depends on your legal status:

  • Naturalized U.S. citizens are eligible for all Obamacare benefits, including the expansion of California's Medicaid program for low-income residents, which is called Medi-Cal.

    They also can receive tax credits for plans purchased through the state's health insurance exchange, Covered California (as long as they meet the income guidelines and other qualifications).


    People in most of those categories also will be eligible for expanded Medi-Cal if their incomes qualify. Some states -- but not California -- require a five-year waiting period before allowing certain immigrants to enroll.

  • People who are here illegally cannot participate in any of these programs, but can receive emergency or prenatal treatment, as they do now. They also don't have to comply with the Obamacare requirement.

    Q I'm a legal immigrant who has been in the U.S. for less than two years. I already have private health insurance from my native country (Mexico), which covers me internationally. I can't afford to get another health plan. Am I obliged to buy another health plan here? Will I have to pay the penalty if I don't?

    A Remember that important little detail I mentioned above, Laura? If you're a legal immigrant you have to have health insurance starting Jan. 1.


    Check with your insurer to find out whether it has sought and received approval. If not, you'll need to find coverage that meets Obamacare's standards, qualify for one of the law's exemptions or pay the tax penalty. On the bright side, you may be eligible for tax credits or other financial help.

    Q I recently read that all illegal immigrants' children will be covered under the Affordable Care Act. Can this be true?


    But just because a parent (or parents) are in the country illegally doesn't mean their children are, too. Many such children were born here and are citizens, and are eligible for health care benefits.


    "Most immigrants live in mixed-status families," Rejeske says. "You may have an undocumented parent who's not eligible for anything. There may be a citizen child who's eligible for Medi-Cal. You may have a lawfully present parent who is eligible for the exchanges."

    She ends with my favorite Obamacare truism: "It can get very complicated."


    A This question is related to the DREAM Act. That's the bill -- as of yet unapproved -- that would permit some immigrant youth who were brought to the U.S. illegally by their parents to apply for temporary legal status. That status could lead to U.S. citizenship if they went to college or served in the military.




    If you actually want insurance, however, you can't buy it from Covered California. DACA recipients are barred from the health insurance exchange.


    If you have questions for Emily, email
