Mohan Iyer has been in a bind. He's lived in the U.S. since he came here for college from India in 1980. He ultimately got a job, a green card and became a citizen in 1994. Most of his siblings live here now, too.
After his father passed away two years ago, Iyer and his siblings have wanted their mother to move here. But there's one big problem: she is effectively barred from any kind of reliable health insurance.
"Health care has been a big issue," said Iyer, who is 50 and lives in Menlo Park.
That's because new immigrants over age 65 are not eligible for Medicare. For legal immigrants like Iyer, who are people of working age, the impossibility of obtaining health insurance for their parents has been a barrier in their hopes of moving aging parents or grandparents to the U.S.
Americans over 65 tend not to worry much about health insurance, because of Medicare, the government insurance program for the elderly and the disabled. But while Medicare is available to virtually all citizens, starting at age 65, immigrants legally present in the U.S. for less than five years are not eligible.
And because of the very existence of Medicare, private insurance companies generally do not offer health insurance plans for those over 65. "There are health insurance options," Iyer said, "but these are usually catastrophic traveler's insurance. They usually have a very high deductible and they're expensive."
They also tend to exclude pre-existing conditions, he said.
"We've heard horror stories of elderly parents visiting their kids here, having a fall or a cardiac problem and the bill arrives in the range of $100,000."
As our conversation went on, Iyer was clearly at a loss of what to do. "It's one thing to say I'll support my mom, and another to say I'm ready for a sudden, six-figure bill that I have to cover."
I asked him if he was aware that immigrants, even those here less than 5 years (a big cutoff point in immigration policy) were eligible to purchase health insurance In the Covered California marketplace, the new exchange set up to comply with the Affordable Care Act.
Iyer lit up. "Oh, really? Wow, that is huge!" he exclaimed. "This has been something I've been sweating." He said that finding peace of mind on this issue would be "a huge deal."
Tanya Broder in the Oakland office of the National Immigration Law Center said there's "a lot of confusion" about immigrants and the ACA. "Most of the outreach materials and most of the material online are directed at citizens."
She pointed out that the ACA seems to make the presumption that most people over 65 are receiving Medicare.
"But there's nothing prohibiting someone who is lawfully present in the U.S. but ineligible for Medicare or Medicaid from purchasing coverage in the exchange," Broder said.
Obamacare provides new options for immigrants under age 65 as well. California is participating in the Medicaid expansion, called Medi-Cal in California. For the first time, individuals (citizens and legal immigrants alike) who do not have children and are not disabled can apply to the program, as long as their income is less than 138 percent of poverty, about $15,500. Immigrants must be here legally, but they do not need to have a green card.
We have more detail in our popular Obamacare Guide. Click on the "I am an immigrant" section.