Overview of Immigrant Eligibility for Health Insurance Affordability Programs in Colorado Sitora Rashidova Community Health Center Outreach and Enrollment Coordinator Covering Kids and Families May 17, 2016
Who We Are Colorado Covering Kids and Families (CKF) is a statewide, coalition-based project that works to ensure Coloradans are able to enroll and stay enrolled in high quality, affordable health coverage CKF is a project of the Colorado Community Health Network (CCHN), the membership association of federally qualified Community Health Centers (CHCs) in Colorado
Presentation Overview Immigration Basics Eligibility Overview Sponsor Deeming Coverage for Seniors Coverage for Undocumented and DACA Immigrants Application Challenges Resources
Immigration Basics The U.S. immigration system based on three principles: 1) reunification of families 2) admitting immigrants with skills that are valuable to U.S. economy; and 3) protecting persons fleeing persecution and for other humanitarian reasons Naturalized U.S. Citizens To become eligible to apply to naturalize, an individual must have had LPR status for at least five years (some exceptions) Undocumented immigrants Individuals who lost permission to remain in the U.S., or entered the U.S. without permission
Eligibility for Health Insurance Affordability Programs Immigrant Categories Medicaid for Adults Medicaid and CHP+ for Children and Pregnant Women Marketplace Coverage Qualified Immigrants Exempt from the Five Year Bar (e.g. refugees, asylees, Cuban/Haitian entrants, active duty military, granted withholding deportation, trafficking survivors, Afghan/Iraqi special visa holders) Qualified Immigrants Subject to the Five Year Bar (e.g. green card holders/lprs, individuals paroled for at least one year, conditional entrants, American Samoans, battered spouse, child, and parent) Eligible; no five year lawful presence waiting period required Eligible after five-years of lawful presence; until then, eligible for Emergency Medicaid only. Eligible; no five year lawful presence waiting period required Eligible Other Lawfully Present Immigrants (e.g. deferred action, deferred enforced departure, applicants for asylum, withholding of deportation, TPS, registry, etc.) Eligible for Emergency Medicaid only Eligible; no five year lawful presence waiting period required; may need employment authorization Eligible; may need employment authorization Undocumented Immigrants and DACA Grantees (DACA status does not include other deferred action granted individuals) Eligible for Emergency Medicaid only Not eligible.
FPL Immigrant Eligibility in Medicaid Expansion States like Colorado Unsubsidized 400% 300% PTC Eligible 200% PTC Eligible 138% 100% Eligible for Premium Tax Credits Medicaid Expansion Lawfully present and Not eligible for Medicaid based on immigration status Meets Medicaid Immigration Eligibility Requirement
7 Sponsor Deeming Federal law allows states, but does not require them, to deem a sponsors income as their own when applying for public benefits. Not allowed for lawfully present pregnant women or children enrolled in Medicaid or CHP+ Not allowed for Connect for Health Colorado coverage or premium tax credit Certain hardship exemptions, e.g. for Old Age Pension recipients: https://www.colorado.gov/pacific/sites/default/file s/oap-sponsor_deeming_for_non-citizen.pdf
Lawfully Present Immigrant Seniors Medicare has different immigrant eligibility rules o o qualifying work history immigration status restrictions and waiting periods Some lawfully present seniors, including LPRs, are not eligible for Premium Free Medicare because they lack qualifying work history. o They may be eligible only for Premium Buy-in Medicare which may cost more than marketplace coverage with premium tax credits and cost sharing reductions Lawfully present seniors who are not eligible for Premium Free Medicare are eligible for Connect for Health CO
Eligible for: Emergency Medicaid Undocumented & DACA Immigrants Private coverage outside of the marketplace Kaiser Permanente s Colorado Bridge charitable health coverage program Federally qualified Community Health Centers http://cchn.org/map/ Certain public health programs Exempt from the individual mandate to have health insurance coverage at tax filing If applying for premium tax credits on behalf of eligible family members, must file a tax return
Common Application Challenges Systems challenges o Renewals o Reporting changes/immigration status Public charge Protection from immigration authorities
Resources CKF s Outreach and Enrollment Toolkit: Immigrant O&E http://cchn.org/ckf/outreach-andenrollment/oetoolkit/ (includes resources in other languages, links to webinars, and job aids) PEAK Outreach Initiative: Guide to entering LPR Information Building Better Health 2015 session slides on working with immigrants
Thank you! Sitora Rashidova, CKF CHC Outreach and Enrollment Coordinator, sitora@cchn.org For more information, visit ckf.cchn.org To join the CKF coalition, go to http://ckf.cchn.org/form/subscribe-css.html