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What does the Affordable Care Act (ACA) mean for Immigrants?

The Patient Protection and Affordable Care Act (also called Obamacare, healthcare reform, the Affordable Care Act, or the federal healthcare law) is a United States federal statute that was signed into law by President Barack Obama on March 23, 2010. This law represents the most significant overhaul of the United States healthcare system since the creation of Medicare and Medicaid in 1965. The Affordable Care Act is designed to protect consumers, provide new coverage options, and give you the tools you need to make informed informed choices about your health[1].

Through the Affordable Care Act, an estimated 900,000 Illinois residents will gain access to health insurance. Currently, lawful permanent residents are more than twice as likely as U.S. citizens to lack health insurance[2] and for Latinos specifically, more than half of adults are uninsured[3]. While the ACA does not fully encompass all immigrants, the law will make significant headway in providing affordable health insurance to many of Illinois' residents, resulting in healthier communities across the state.

Outside of the annual Open Enrollment Period, you generally can enroll in a health insurance plan only if you qualify for a Special Enrollment Period. You may qualify if you have certain life events such as getting married, having a child, or losing other health coverage. Visit healthcare.gov for more information.

What did the Affordable Care Act (ACA) do for immigrants and refugees?

I am undocumented:

  • You are not allowed to purchase private health insurance in state insurance exchange(s).

  • You are not eligible for premium tax credits or cost-sharing reductions.

  • You are exempt from the individual mandate.

  • You are not eligible for Medicare, nonemergency Medicaid, or CHIP.

  • You remain eligible for emergency care under federal law.

  • You may seek nonemergency health services at community health centers or safety-net hospitals.

  • You remain eligible for Moms & Babies.

I am here on a Visa OR have had a green card for less than 5 years:

  • You are subject to the individual mandate and related tax penalty (exempt if low income or meet specific exemptions).

  • You may purchase from the state insurance exchanges.

  • You are eligible for premium tax credits and cost-sharing reductions.

  • You are eligible for temporary high-risk pools and "basic health plans" offered by a state.

  • You do not have to wait to enroll in state insurance exchanges or to get premium tax credits.

  • You may seek nonemergency health services at community health centers or safety-net hospitals.

I have had a green card for more than 5 years:

  • Same as above for someone having a green card for less than 5 years

  • You may be eligible for Medicaid if you are low-income. As of 2014, all adults with incomes at or below 138% of the federal poverty line (for example, $33,465 for a family of four in 2016), whether they have dependent children or not.

I am a naturalized citizen OR a refugee:

  • You are subject to the individual mandate and related tax penalty (exempt if low-income or meet specific exemptions).

  • Same access and requirements for affordable coverage as U.S.-born citizens.

  • You can purchase own insurance from the state insurance exchange(s).

  • You are eligible for premium tax credits and cost-sharing reductions.

  • You are eligible for temporary high-risk pools and "basic health plans" offered by a state.

  • If low-income and under 65 years old, you may qualify for Medicaid. As of 2014, all adults with incomes at or below 138% of the federal poverty line (for example, $33,465 for a family of four in 2016), whether they have dependent children or not.

I am under 18 years old:

  • You qualify for ALL KIDS (provides free or affordable medical insurance for children in Illinois, covers children with family income under 300% of the federal poverty level, regardless of immigration status).

  • Your parents can purchase insurance for you from the state exchanges (citizen or lawfully present immigrant children eligible for premium tax credits and cost-sharing reductions).

Fact sheets about ACA for Immigrants: English and Spanish

ICIRR is dedicated to promoting the rights of immigrants and refugees to full and equal participation in the civic, cultural, social, and political life of our diverse society.
©2023 Illinois Coalition for Immigrant and Refugee Rights
228 S. Wabash, Suite 800
Chicago, Illinois 60604
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