Can immigrants get help paying premiums and/or cost-sharing for health insurance in the health insurance Marketplaces?

Individuals with no coverage | Navigating Health Insurance Marketplace Options |

Lawfully present immigrants can qualify for tax credits to help pay premiums and cost-sharing for health insurance through the Marketplaces. Like citizens, they can get tax credits to help pay premiums. The Affordable Care Act made premium tax credits available to people who buy Marketplace coverage and whose household income is between 100 percent and 400 percent of the federal poverty level. (26 C.F.R. § 1.36B-2(b).) Congress has subsequently extended eligibility for tax credits to individuals earning more than 400 percent of the federal poverty level, through plan year 2025.

Cost-sharing for Marketplace plans will also be lowered if you make between 100 percent and 250 percent of the federal poverty level. To get this help, you cannot be offered affordable health insurance through your job or be eligible for Medicaid.

If you are a lawfully present immigrant who makes less than 100 percent of the federal poverty level, you also can get help paying premiums and cost-sharing if you cannot enroll in Medicaid based on your immigration status. Many lawfully present immigrants cannot enroll in Medicaid until they have been in the United States for five or more years.

In most states, undocumented immigrants cannot receive help paying for premiums or cost-sharing for Marketplace coverage and may not buy health insurance through the Marketplaces even at full cost. (42 U.S.C. § 18071; 26 C.F.R. § 1.36B-2(b); CMS, Immigrant Eligibility for Marketplace and Medicaid and CHIP Coverage.)

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