August 4, 2015 by Tony Novak
I’ve noticed that public discussion of the topic of health insurance for immigrants seems to be influenced by political opinions or perceptions of health care reform overall and opinions about the political process of immigration reform. The issue became even more politicized after President Obama announced policy changes affecting immigration in November 2014 and the state of California announced plans to extend its Medicaid plan to cover undocumented immigrants. Recent news reports include inaccurate statements about both legal and undocumented immigrants in explaining consumers’ behavior toward health insurance. The issue seems likely to become more disputed if immigration policy becomes a key point in the 2016 presidential election.
One in every 7 people now in the U.S. was born outside of this country and then came into the United States; a higher ratio of our population than at any time since the early 1920s. So this issue of health insurance options for this segment of the population is more important than ever.
This post is an attempt to lay out just the facts about the immigrant situation without any political slant. The insurance sources and links for both both documented and undocumented immigrants refer to references published at Freedom Benefits.
1) There are about 30 million legally present immigrant non-citizens in the U.S.
2) Immigrants legally entering the U.S. are required to have health insurance at the time of entry.
3) Insurance industry data experience indicates that most legal immigrants keep their health insurance coverage after entry in the U.S.
4) Most documented immigrants must have health coverage or pay a fee (also known as “the penalty,” the “individual shared responsibility payment,” or the “individual mandate”).
5) Some documented immigrants without insurance will not have to make a tax penalty payment. This is one of the exemptions to the individual health insurance mandate under the Affordable Care Act.
Suggested insurance resources for documented immigrants:
a) International travel medical insurance is typically used to gain entry to the U.S.
b) Inbound Immigrant insurance typically offers the best value prior to eligibility for the insurance exchanges or employer provided coverage for the first few years after entry tot he U.S.
c) The government-run Health Insurance Marketplace (Healthcare.gov or state site) is the best option if (and when) an applicant qualifies for a premium tax credit subsidy or a Medicaid program.
1) There are estimated to be 11-15 million undocumented immigrants in the U.S. now. The number is increasing, but growing at a slower pace than in the past.
2) More than 70 percent of U.S. agriculture workers are undocumented immigrants, according to estimates from growers and labor unions. (In my state and particularly in my local region of southern New Jersey the percentage is likely even higher).
3) 8.2% of the total work force of the State of New Jersey are undocumented workers. They are concentrated in occupations that earn about $25,000 per year, less than half of the median income in the state. (Other states have lower rates of undocumented workers).
4) Certain classes of undocumented immigrants are immediately protected and can begin the process of identifying themselves without fear of deportation.
5) Newly protected immigrants living in California (the state that hosts 1/5 of undocumented immigrants) will be eligible for Medi-Cal (the state’s name for Medicaid) if they qualify based on income.
6) Federal Medicaid law requires that all states provide basic medical care to all undocumented immigrants regardless of insurance coverage.
7) Undocumented immigrants are not eligible to buy health coverage through the Marketplace. They’re not eligible for premium tax credits or other savings on Marketplace plans.
8) Undocumented immigrants are eligible to buy health insurance through private exchanges, agents and directly from insurance companies.
9) Undocumented immigrants are exempted from the individual mandate to carry health insurance.
10) About 40 percent of undocumented immigrants receive employer-based health insurance.
11) Short term seasonal employers of undocumented immigrants increasingly indicate that they are willing to provide some type of health insurance but this is typically mini-med or supplemental health insurance but in most cases it is not Obamacare coverage.
12) International travel insurance and Inbound Immigrant insurance are offered without regard to legality of residence status.
13) Health insurance companies do not report legal status to a government agency.
14) Health insurance information may not be used for any type of civil immigration enforcement action under U.S. Immigration and Customs Enforcement law.
15) There have been no substantiated instances of breach of security or improper use of information between health insurance companies and U.S. Immigration and Customs Enforcement.
16) A social security number is not required to obtain health insurance.
Suggested insurance resources for undocumented immigrants:
a) Inbound Immigrant insurance typically provides the best available value option for the time immediately after arrival in the U.S. and before employer-provided coverage is available. No documentation of legal status is required. No social security number or ITIN is required.
b) Limited benefit employer-provided coverage i available even for seasonal workers. Some employers provide minimal low cost coverage for these workers, even if just for emergencies.
b) Private health insurance exchanges like Members Insurance Exchange and health insurance companies direct enrollment channels offer Obamacare without subsidies to undocumented immigrants. Note that a social security number is not required on any insurance exchange to obtain insurance if the applicant is paying the full cost.