By Charlotte Kaye, Health Policy Fellow

Following up on our blog last week entitled “Immigration and Health: What’s the Connection?” CCHI thought it was important to also examine the impacts of the Affordable Care Act’s impact on documented immigrants. 

According to the Department of Homeland Security (DHS) Office of Immigration Statistics, over one million people are granted legal permanent residencies every year, which equates to one million more people who should be able to count on insurance to see their doctor when they need to without unpredictable costs. The good news is that the federal subsidies offered under the ACA to those citizens at or below 400% of the Federal Poverty Line (FPL) will also apply to lawfully residing non-citizens if they do not already receive affordable health insurance from their employer. For example, a 40-year-old earning $29,000, paying a premium of $350 per month could qualify for a subsidy of up to $154 per month and would contribute $196 per month.

Most documented immigrants will be eligible for the exchange and be expected to purchase health insurance except those in the lowest income bracket.  Those lawfully residing non-citizens under the 138% FPL who have resided in the United States for less than five years, however, will have a hard time abiding by the ACA guidelines. These documented immigrants will not be allowed to enroll in Medicaid until they have lived in the United States for five years or more. They will qualify for subsidies if they buy into the exchange and are paying over 2% of their income. This could end up being a huge expense for many individuals and families who are already struggling to get by.  Plus, these less expensive plans in the exchange may not be as comprehensive as its Medicaid counterpart.  Those documented immigrants, including children, living in the United States less than five years who would not qualify for Medicaid if they were an adult can receive subsidies in the exchange if their state does not cover them under Medicaid, CHIP, or other state funds.  Colorado had already passed legislation a few years ago to waive the five-year bar for Colorado’s Child Health Plan Plus (CHP+), but it has never been implemented because there are not enough state dollars to fund the under five population that could potentially qualify for CHP+.

According to the last United States’ Department of Homeland Security Report over 13,000 people received legal permanent residency in Colorado in 2012. Almost 3,000 of those people were under the age of 18.  As one of the fastest growing states in the country, Colorado needs to consider how our state’s newest lawfully residing non-citizens and permanent residents will get the care they need when they need it. It’s not too much to ask.  

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