The United States Patient Protection and Affordable Care Act (PPACA), commonly known as Obamacare or the health care reform law, was passed in 2010. It created a first-of-its-kind opportunity for more Americans to access health insurance. One of the best benefits of the program is that it subsidizes health insurance premiums for citizens who can’t afford regular premiums. Obamacare benefits also are available to immigrants who enter the United States. They must be lawfully present in order to be eligible, but immigrants who aren’t lawfully present or undocumented may have other health insurance options while they are in the United States.

It’s important to check carefully before applying for the PPACA, so you understand what lawfully present means. For example, immigrants who have received benefits under the Deferred Action for Childhood Arrivals (DACA) or Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) are not considered legally present, and therefore are not eligible for benefits through Obamacare, Medicaid or the Children’s Health Insurance Program (CHIP). Immigrants who are incarcerated (in jail or prison) are not considered legally present.

A person’s status as a state resident doesn’t necessarily prove citizenship or lawful presence for the purposes of qualifying for coverage under the PPACA. Each state has different rules determining eligibility of immigrants for state-sponsored and state-run programs such as Medicaid and CHIP.

Lawfully present immigrants DO include individuals with:

• Qualified non-citizen immigration status without a waiting period
• Humanitarian statuses or circumstances (including victims of trafficking, asylum applicants, Convention Against Torture, Special Juvenile Status, and Temporary Protected Status)
• Legal status through other laws, such as Family Unity, temporary residency, and the LIFE Act.

A complete list of immigrant statuses that qualify for use of the PPACA Marketplace can be found here: https://www.healthcare.gov/immigrants/immigration-status/,
If immigrants are eligible for Obamacare, they must maintain minimum coverage or pay a fine. No one is automatically eligible, which means anyone who wants coverage must apply officially during open enrollment periods. In 2015, this is from Nov. 1, 2015, through Jan 31, 2016.

Does healthcare coverage trigger immigration enforcement?

Some families might worry that applying for Obamacare could trigger immigration enforcement and jeopardize the status of non-citizens or illegal family members. Although there are laws against undocumented immigration, the PPACA includes clauses that ensure no Obamacare contact can result in immigration enforcement. Marketplace, Medicaid and CHIP representatives are not allowed to ask for any information about family members who aren’t applying for Obamacare.

This “unlinking” of the PPACA and immigration enforcement means even undocumented family members can help dependents who do qualify to sign up for healthcare coverage through Obamacare. Many of these lawfully present dependents are children born in the U.S. to undocumented parents.

Healthcare coverage options for undocumented immigrants

Those who do not have a way to document lawful presence are not required to get coverage, and they do not have to pay a fee for not getting coverage through Obamacare. However, the country’s more than 11 million undocumented residents still have healthcare and insurance coverage concerns.

Some states, including New York, have limited exceptions that make it possible for certain undocumented immigrants to enroll in Medicaid and CHIP. However, most permanent legal residents must wait five years to become eligible for Medicaid and the PPACA. For these people, other options are available to fill healthcare coverage gaps.

For example, immigration status isn’t usually an issue for college students applying for healthcare coverage. In fact, some colleges and universities have rules requiring students to either purchase private insurance and provide proof or purchase a school health insurance plan.

Undocumented immigrants who work for employers that offer health benefits are eligible to sign up for these policies, which are usually less expensive than private insurance. However, the employer must include the workers on the payroll in order for them to be eligible for group insurance.

Any undocumented immigrant can buy private insurance, but it can be expensive and no subsidies are available. Private policies also levy large premium increases for negative habits, such as smoking, and bad health conditions.

Some states provide inexpensive health care with no requirements for proving citizenship or immigrant documentation. These programs often cover healthcare needs, such as emergency care. Some programs cover services for pregnant women and those who need extended care. Each state’s programs are different.

Special programs can be found for children at minimal cost, and the country is full of community and county health centers, where undocumented immigrants can get primary care. Federally Qualified Health Centers can be found on the website of the U.S. Health Resources and Services Administration: http://www.findahealthcenter.hrsa.gov/help.

To learn more about ways immigrants can get healthcare assistance through Obamacare, call the Marketplace at 1-800-318-2596 / TTY: 1-855-889-4325, 24 hours a day. Other helpful information can be found on the Obamacare website at https://www.healthcare.gov/immigrants/.