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Obamacare Explained: A Guide for Californians

Produced by KQED News and The California Report

I am an Immigrant

At a Glance

  • Naturalized citizens are eligible for the same benefits as U.S.-born citizens.
  • Most lawfully present immigrants are eligible for benefits under the Affordable Care Act and, like citizens, may be required to pay a penalty if they do not have health insurance.
  • Some immigrants previously not eligible for Medi-Cal may now have access to health insurance, either under the Medi-Cal expansion or in the new Covered California marketplace. Subsidies are available to those who qualify.
  • Undocumented immigrants are not eligible for benefits under the ACA and do not have to pay a fine if they do not have health insurance.


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California has more immigrants than any other state. About 10 million foreign-born people live here, and just under half of them are naturalized citizens. Of the rest, many are living here lawfully; others are not. Whether they are eligible for the benefits of the ACA depends on their immigration status.

I Already Have Health Insurance. Do I Have to Do Anything Differently Because of the Affordable Care Act?

In short, if you already have insurance, nothing about your situation changes. There are some limited exceptions, but in general, if you have insurance through your job, or public insurance such as Medi-Cal or Medicare, you will continue to be insured through those programs.

I Am a Naturalized U.S. Citizen, and I Do Not Have Health Insurance. How Does the ACA Affect Me?

As a naturalized U.S. citizen you are eligible for the same benefits under the ACA as a U.S.-born citizen. Depending on your income, you may be eligible for Medi-Cal or for subsidies to help you afford insurance in the Covered California marketplace. You may need to pay a penalty if you do not have health insurance. Please consult the other sections of this guide for information about your rights and responsibilities under the health law.

I Have a Green Card. How Does the ACA Affect Me?

If you are a green card holder, then you are eligible for the same benefits as U.S. citizens under the health law. Green card holders are also called lawful permanent residents.

If you do not have health insurance, the ACA can help you get it. The health law provides two paths to assist you: through a new health insurance marketplace called Covered California, and through an expanded Medi-Cal program — the government's health insurance program for the poor. Your income will determine which one of these programs is for you. Please consult the I'm Not Insured section of this guide for a more complete explanation of benefits and how you can enroll.

Important note for lawfully present immigrants who are childless adults: Before the health law went into effect on Jan. 1, 2014 low-income childless adults were not eligible for Medi-Cal. But under the health law, they are now eligible. California is expanding Medi-Cal to include more people. If you have been denied in the past, you can submit an application to Medi-Cal via Covered California or at your county social security office.

I Am in the U.S. Legally, But I Do Not Have a Green Card. I Am Here under a Different Kind of Visa. What Does the Health Law Mean to Me?

U.S. law includes a wide variety of ways in which immigrants can be "lawfully present," even if they are not green card holders.

The Affordable Care Act provides benefits to immigrants lawfully present under many different kinds of immigration status. You can check this list from the federal government to see if you qualify.

If you do qualify, please visit Covered California section of this guide to learn more about the benefits available to you.

Depending on your income and the number of people in your family, you may be eligible for subsidies to help you pay for insurance. If you earn less than 400 percent of poverty ($47,080 for an individual or $97,000 for a family of four), you likely qualify for a subsidy.

Covered California has a cost calculator so you can estimate how much, if anything, you might have to pay for health insurance. The cost calculator will also indicate if you are eligible for Medi-Cal.

Even if you make too much money to qualify for a subsidy, you can still purchase health insurance on the Covered California marketplace. But those who do not qualify for subsidies may choose to consult an insurance broker or do other research, as there may be more options for you outside the Covered California marketplace.

I Am Lawfully Present and Want My Parents to Immigrate. Are They Eligible for Any Benefits?

If your parents are lawfully present, they are eligible to buy insurance on the Covered California marketplace. They may also be eligible for subsidies, depending on their income.

We Are a Mixed-Status Family. How Do We Handle Our Application?

A mixed-status family is a household of individuals present in the United States under different immigration or citizenship statuses. While undocumented immigrants are not eligible for benefits under the health law, lawfully present members of a mixed-status family likely are eligible for benefits. Please consult this document from the National Immigration Law Center.

I Am An Undocumented Immigrant. Can I Buy Insurance on the Marketplace?

In short, no. Under the health law, undocumented immigrants are not eligible for benefits. You are not eligible for subsidies on Covered California. Undocumented immigrants are also barred from purchasing health insurance on the Covered California marketplace, even if they use their own money. As an undocumented immigrant you do not have to pay a fine if you do not have health insurance.

Adults are not eligible for Medi-Cal, but under a new state law, starting in May, 2016, undocumented children will be eligible for Medi-Cal, if their family meets income requirements.

In extraordinary circumstances undocumented immigrants may be eligible for a program called "Emergency Medi-Cal." For example, a woman who is pregnant is eligible for Emergency Medi-Cal for prenatal care and the delivery of her baby.

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