The Patient Protection and Affordable Care Act, commonly known as Obamacare, is a measure to expand access to healthcare and reduce the number of uninsured Americans through government-assisted healthcare plans and an expanded Medicaid program. The act affects all Americans, but it will have an especially important impact on U.S. immigrants.

Immigrants make up a disproportionately high percentage of Americans living without health insurance, and Obamacare’s qualifications for immigrants can be more complex than the requirements for native born U.S. citizens. Immigrants are more likely to work in jobs and industries that do not offer health coverage, and they are much more likely to go without needed care. Non-citizens in the U.S. are just as likely as U.S. citizens to have a full-time worker in the family, but they are much more likely to be from a low-income household. According to a recent study, 46% of non-citizens are uninsured and 23% of naturalized citizens are uninsured, compared to just 15% of all U.S. born citizens.

Obamacare will also directly impact the U.S. Latino population since almost 30% the uninsured population in the U.S is Latino. The U.S. government has even launched a Spanish-language site about Obamacare’s health coverage plans to address this specific group.

Health Insurance, Obamacare, and Undocumented Immigrants

Although one of the main goals of Obamacare is make sure every American has health insurance, many immigrants will not qualify for it – particularly the 11.7 million unauthorized immigrants currently living in the U.S.

Some undocumented immigrants have expressed concern that Obamacare exposes their unlawful status, putting them at greater risk for deportations and other issues. All other Americans will be required by law to sign up for health insurance, leaving undocumented immigrants as the only large group in the U.S. without coverage. It’s important to remember, however, that Obamacare is not the only health care option for undocumented immigrants. Some still may qualify for other health coverage in certain states, as well as private health coverage if it is offered by their employer. They also do not face a penalty for failing to obtain coverage. As always, they are still entitled by law to emergency care, even though they must pay their medical costs in full.

The roughly 500,000 undocumented young adults who have DACA (Deferred Action for Childhood Arrivals) will not qualify for services offered by the Obamacare plan, including Medicaid. Individuals who received an order of deferred action for other reasons can still qualify for Medicaid.

Undocumented immigrants with U.S. citizen children can enroll their children in Obamacare programs, but they do not qualify.

Immigrant groups that qualify for Obamacare’s insurance plans but cannot get Medicaid

  • Legal permanent residents (green card holders) who have been here for less than five years
  • Immigrants with temporary work and student visas (H-1B, E-2, F-1, J-1)

Immigrant groups that qualify for Obamacare coverage plans and Medicaid

  • Naturalized U.S. citizens
  • Green Card Holders/LPRs who have lived here for 5+ years
  • Refugees, asylees, and other special immigrant groups exempt on humanitarian grounds

Challenges for immigrants who qualify for Obamacare

A great deal of uninsured U.S. immigrants will have to overcome language and literacy barriers, misinformation, fear of immigration enforcement, concerns about their immigration sponsors, and confusion regarding their eligibility to obtain the Obamacare plan they need, so it is uncertain how many will actually apply for benefits at first.  For the near future, many immigrants will continue to work with free or low-cost providers they already use and trust ““ local clinics and nonprofit organizations. It will be important to address these challenges in the months ahead as millions of immigrants enroll in the program.