How the Affordable Care Act Affects Documented and Undocumented Immigrants

Oct. 1 marks the start to the implementation of President Obama's signature health care overhaul law, the Affordable Care Act, better known as "Obamacare." Starting this month, people will be able to sign up for new insurance policies that begin Jan. 1, when the law's major provisions go into effect.  

This law will affect millions of Americans across the nation, yet many are still unsure of exactly how. Health coverage is especially troublesome for the 21 million plus immigrants who are not citizens and live in the U.S. because many of them work in low wage jobs that don't include health coverage. The Affordable Care Act will help some immigrants gain coverage, although those living in the country illegally will not get access to federal subsidies or to insurance sold through new state-based exchanges. 

But, for immigrants who will not be exempted, the health law is expected to boost coverage, either through private insurers or in Medicaid, the state-federal health program for low-income residents, reports Philly.com.

Obamacare will entitle documented immigrants earning more than the Medicaid limit to qualify for a federal subsidy to purchase coverage through the exchanges. This provision will help individuals who earn up to $46,000 a year, four times the poverty level.

However, the health law does not provide coverage or subsidies to the 11 million undocumented immigrants living in the country. These individuals are also barred from using their own money to purchase insurance coverage through the state exchanges. As a result, the Congressional Budget Office estimates that about 30 million people will remain uninsured in 2016. 

Undocumented adult immigrants are currently unable to participate in Medicaid or Medicare and that won't change, either. But unlike most other groups, they won't face a penalty for not having insurance.

Although undocumented workers will not qualify for coverage, they will still be legally allowed to use emergency rooms based on federal law. Plus, low-income workers who would otherwise be entitled to Medicaid if not for their immigration status, can qualify for emergency Medicaid for emergent conditions, such as heart attacks. Coverage for low-income pregnant women will also still be available regardless of their immigration status.

Undocumented workers also have the option of using the nation's 8,500 community health centers, which serve about 22 million people. About 40 percent of patients that use these centers are uninsured, and the facilities do not ask about immigration status.

The law also boosted funding for the National Health Service Corps, which helps bring primary care services to underserved populations.

According to the National Immigration Law Center, citizens or lawfully present children of undocumented parents are eligible to purchase from the state insurance exchange, for premium tax credits and lower copayments and for Medicaid or CHIP.