Lawfully Present
Coverage for lawfully present immigrants
Right Now (but changes on January 1, 2027)
Low-income, lawfully present immigrants in some cases may not be able to receive Medicaid because of their immigration status. But they may enroll in plans through the Marketplace and are eligible for subsidies in the form a premium tax credit.
The term lawfully present includes immigrants who have:
• Qualified non-citizen immigration status without a waiting period
• Humanitarian statuses or circumstances
Temporary Protected Status
Special Juvenile Status
Asylum applicants
Convention Against Torture
Victims of trafficking
• Valid non-immigrant visas (includes work visas & student visas)
• Granted relief under the Convention Against Torture (CAT)
• Temporary Protected Status (TPS)
• Deferred Enforced Departure (DED) Deferred Action*
• Lawful Temporary Resident
• Legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals) See a full list of immigration statuses eligible for Marketplace coverage.
► *EXCEPTION: Individuals granted deferred action under the Deferred Action for Childhood Arrivals (DACA) program are not eligible to enroll in coverage at the Marketplace. — Nov. 1, 2024 this changed. A new HHS rule took effect allowing DACA individuals to apply for ACA health plans.
→ 19 Republican states sued to stop DACA recipients from enrolling in ACA plans.
♦ On December 16th - the 8th Circuit Court of Appeals stays an earlier Federal Judge's decision to suspend the HHS rule. DACA individual can still enroll in ACA plans while the Appeals court decides.
► DACA update - the Trump administration changed the HHS rule back so that DACA individuals will no longer be eligible to enroll in ACA health plans. This new HHS rule took effect on August 25, 2025.
If you’re a lawfully present immigrant, you can buy private health insurance on the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income.
• If your annual income is 400% of the federal poverty level or below, you may be eligible for premium tax credits and other savings on Marketplace insurance.
• If your annual household income is below 100% federal poverty level and you are not eligible for Medicaid you may be eligible for premium tax credits and other savings on Marketplace insurance.
Starting January 1, 2027
Under federal policy changes established by H.R. 1, the group of lawfully present immigrants who can purchase an ACA Marketplace plan depends heavily on whether they are paying full price or seeking financial assistance.
Who Can Purchase a Plan?
All lawfully present immigrants retain the right to buy an insurance plan through HealthCare.gov or state-based exchanges for 2027, provided they pay 100% of the premium out-of-pocket.
This comprehensive list of eligible statuses includes:
- Lawful Permanent Residents (LPRs or Green Card holders)
- Refugees and Asylees
- Temporary Protected Status (TPS) holders
- Valid non-immigrant visa holders (e.g., H-1B, H-2A, student visas, F-1, J-1)
- Humanitarian parolees (paroled into the U.S. for at least one year)
- Individuals with valid Employment Authorization Documents (EAD/work permits)
- Victims of trafficking (T-visas) and crime (U-visas)
Who can qualify for subsidies (premium tax credits)?
While anyone listed above can enroll in a plan, starting January 1, 2027 there will be strict limits on who can receive Premium Tax Credits (PTCs) and Cost-Sharing Reductions (CSRs) to lower their monthly bill.
Only a very narrow subset of lawfully present immigrants can qualify for subsidies:
- Lawful Permanent Residents (LPRs / Green Card holders)
- Cuban and Haitian entrants
- Compact of Free Association (COFA) migrants (citizens of the Marshall Islands, Micronesia, and Palau)
Qualified non-citizen
► In order to get Medicaid and CHIP coverage, many qualified non-citizens who entered the U.S. on or after August 22, 1996 have a 5-year waiting period.
Lawful Permanent Residents (Green Card holder) — who were not previously a refugee or granted asylum
Paroled into the U.S. for at least one year - Trump administration has eliminated eligibility entirely for this group.
Conditional entrant granted before 1980 - Trump administration has removed this group from eligibility.
Battered non-citizens, spouses, children, or parents - Trump administration stripped funding for this group.
The following qualified immigrants do not have a 5-year waiting period:
Green Card holders who used to be refugees or granted asylum don’t have to wait 5 years.
Individuals granted withholding of deportation / removal
Cuban / Haitian entrants
Veterans or individuals on active military duty and their spouse (un-remarried surviving spouse), or child
Member of a federally recognized Indian tribe or American Indian born in Canada - Trump administration changed this group to exclude American Indians if born in Canada. Indians born in American are US Citizen so they are qualified.
• Tribal members are entirely exempt from the new federal Medicaid "community engagement" or work requirements.
Individuals receiving Foster Care - children and teenagers currently in the foster care system automatically qualify for full Medicaid coverage. Things get complicated if the foster care individual is a non-citizen legal immigrant.
In most states, Supplemental Security Income recipients qualify for Medicaid.
♦ A few states restrict eligibility even after a 5-year waiting period.
Source: Medicaid.gov, HealthCare.gov, CMS, HHS
