QUESTION

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
ANSWER

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. In general, premium tax credits are 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)). However, the American Rescue Plan Act of 2021 eliminates the limit on incomes eligible for premium tax credits for plan years 2021 and 2022.

Their plan cost-sharing will also be lowered if they make between 100 percent and 250 percent of the federal poverty level. To get this help, they cannot be offered affordable health insurance through their job or be eligible for Medicaid.

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

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, Assister Guide to the Immigration Section of the Online Marketplace Application; IRS, Affordable Care Act: What You and Your Family Need to Know).

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