Posted in Healthcare
Written by Misa Bailey, Healthcare Program Manager at SC Appleseed
Blog Summary: There are many recent and upcoming changes to immigrant health coverage. First, DACA recipients are losing Affordable Care Act (ACA) marketplace eligibility. There is also a major cut in who qualifies for Medicaid, Medicare, and premium tax credits (PTCs) under the ACA. By 2027, most immigrants lawful status will no longer qualify for these programs.
Only the following will still qualify: Green Card Holders (lawful permanent residents), Cuban/Haitian entrants, and people from Micronesia, Palau, or the Marshall Islands who live in the U.S. under special agreements. Furthermore, very low-income immigrants who are not eligible for Medicaid (due to the 5-year waiting period) will no longer qualify for premium tax credits to help pay for ACA health coverage.
In this blog, we focus on healthcare changes that will impact immigrant communities. We will discuss when they will take place, and how immigrant communities can prepare. Some of these changes started July 4, 2025. More will happen between August 2025 and 2028.
Low-income immigrants will be hit hard by these big changes. These programs will now cover fewer immigrants than before. When certain changes take effect, some immigrants who had coverage through these programs may lose it. It will also be harder for immigrants to sign up for and keep health coverage. Changes will also increase health care costs, and cause many people to lose coverage.
For Undocumented Immigrants: Some states offer state-funded coverage, but that is separate and limited. For those not eligible for Medicaid or CHIP, emergency care services are still provided through Emergency Medicaid, which reimburses hospitals for the care of individuals who cannot pay for it.
WHO WILL BE IMPACTED
The new changes will make access to healthcare essentially impossible for some groups. Some immigrant groups will not be affected.
Who is Still Eligible When New Laws are in Place?
- Lawful permanent resident adults (Green Card holders) who have met the 5-year waiting period. (A lawfully present immigrant is a non-citizen who is approved to live and/or work in the United States under U.S. immigration laws.)
- Cubans or Haitians, with a range of current or past statuses, and
- People from Micronesia, Palau, or the Marshall Islands living in the U.S.
- Lawfully residing children and pregnant adults in states that cover them under the Immigrant Children’s Health Improvement Act (ICHIA) option. If your are pregnant or applying for a child you can apply before five years.
Who is No Longer Eligible When Changes Happen?
- People who came to the US as refugees.
- People granted asylum or withholding of removal (protection from being sent back to their home country);
- Survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act (VAWA);
- Survivors of human trafficking with a pending or approved T visa;
- People with Temporary Protected Status (TPS) and other visa holders (they already not able to get SNAP and Medicaid. Now also lose Medicare and ACA tax credits)
We will now go through the timeline of changes to immigration healthcare access between now and 2028.
NEW CHANGE AS OF JULY 4TH, 2025
Limiting Immigrant Eligibility for Medicare
As of July 4, 2025, all new Medicare applicants must meet the new immigration status requirements. If you do not fall into one of the categories allowed you can no longer apply for Medicare, even if you worked and paid taxes. If you are now enrolled in Medicare, you can keep your coverage until January 4, 2027.
Who Is Still Eligible Under the New Law?
- Lawful permanent resident adults (Green Card holders) who have met the 5-year waiting period.
- Cubans or Haitians, with a range of current or past statuses, and
- People from Micronesia, Palau, or the Marshall Islands living in the U.S.
- Lawfully residing children and pregnant adults in states that cover them under the Immigrant Children’s Health Improvement Act (ICHIA) option. If you are pregnant or applying for a child you can apply before five years.
Who Is No Longer Eligible Under the New Law?
These categories of immigrant no longer eligible:
– People who came to the US as refugees.
– People granted asylum or withholding of removal (protection from being sent back to their home country);
– Survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act (VAWA);
– Survivors of human trafficking with a pending or approved T visa;
– People with Temporary Protected Status (TPS) and other visa holders (they already not able to get SNAP and Medicaid. Now also lose Medicare and ACA tax credits)
Changes for 2026 ACA (Obamacare) Healthcare Coverage
For the ACA marketplace people should expect to deal with these changes now through the 2025 Open Enrollment Period, which starts November 1, 2025 and ends January 15, 2026.
November 1: Low-Income Immigrants Without Medicaid Coverage Will No Longer Qualify for ACA Premium Tax Credits
What This Means: Lawfully present immigrants who earn less than the federal poverty level, but are in the five-year waiting period before they can receive Medicaid were allowed to apply for Premium Tax Credits (PTCs) to help purchase an ACA marketplace plan and receive healthcare coverage. The new law ends this. Now, lawfully present immigrants will no longer qualify for these PTCs. Without PTCs, coverage will become too expensive.
Note: Children and Pregnant women do not have to wait five years to apply for Medicaid, this has not changed. Also, you can still enroll in a Qualifying Health Plan (QHP) without PTCs.
What You Need to Do
If you are a lawfully present immigrant who’s been in the U.S. for less than five years, here’s what to know for the next enrollment period:
- When you apply for 2026 coverage (starting November 1, 2025), you’ll need to show that your income is at or above the federal poverty level:
- $15,650 for one person
- $32,150 for a family of four
- Be ready to provide proof of your income when you apply or renew
Who Is Still Eligible Under the New Law?
- Lawful permanent resident adults (Green Card holders) who have met the 5-year waiting period.
- Cubans or Haitians, with a range of current or past statuses, and
- People from Micronesia, Palau, or the Marshall Islands living in the U.S.
- Lawfully residing children and pregnant adults in states that cover them under the Immigrant Children’s Health Improvement Act (ICHIA) option. If you are pregnant or are applying for a child you can apply before the five year waiting period.
Who Is No Longer Eligible Under the New Law?
These categories of immigrant no longer eligible:
– People who came to the US as refugees.
– People granted asylum or withholding of removal (protection from being sent back to their home country);
– Survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act (VAWA);
– Survivors of human trafficking with a pending or approved T visa;
– People with Temporary Protected Status (TPS) and other visa holders (they already not able to get SNAP and Medicaid. Now also lose Medicare and ACA tax credits)
October 1, 2026: Immigrant Eligibility for Medicaid and CHIP Restricted
What This Means: Starting October 1, 2026, all new Medicaid and CHIP applicants must meet the new immigration status requirements. If you do not fall into one of the categories allowed you can no longer apply for Medicaid. Additionally, Medicaid and CHIP coverage will end for immigrant groups that no longer meet the new status requirements.
Who Is Still Eligible Under the New Law?
- Lawful permanent resident adults (Green Card holders) who have met the 5-year waiting period. (A lawfully present immigrant is a non-citizen who is approved to live and/or work in the United States under U.S. immigration laws.)
- Cubans or Haitians, with a range of current or past statuses, and
- People from Micronesia, Palau, or the Marshall Islands living in the U.S.
- Lawfully residing children and pregnant adults in states that cover them under the Immigrant Children’s Health Improvement Act (ICHIA) option. If you are pregnant or are applying for a child you can apply before the five year waiting period.
Who Is No Longer Eligible Under the New Law?
These categories of immigrant no longer eligible:
– People who came to the US as refugees.
– People granted asylum or withholding of removal (protection from being sent back to their home country);
– Survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act (VAWA);
– Survivors of human trafficking with a pending or approved T visa;
– People with Temporary Protected Status (TPS) and other visa holders (they already not able to get SNAP and Medicaid. Now also lose Medicare and ACA tax credits)
Immigration Healthcare Changes That Will Go Into Effect in 2027
January 1, 2027: Immigrant Eligibility for ACA Premium Tax Credits Restricted
What This Means: Beginning on November 1, 2026 during Open Enrollment, many lawfully present immigrants will no longer qualify for premium tax credits that help make ACA insurance plans more affordable.
Who Is Still Eligible Under the New Law?
- Green Card Holders (lawful permanent residents or LPR: A lawfully present immigrant is a non-citizen who is approved to live and/or work in the United States under U.S. immigration laws.)
- Certain Cuban and Haitian immigrants considered to be “Cuban and Haitian Entran” for benefits purposes under existing benefits law
- People from Palau, Micronesia, or the Marshall Islands who live in the U.S. under special agreements
- Lawfully residing children and pregnant adults in states that cover them under the Immigrant Children’s Health Improvement Act (ICHIA) option. If you are pregnant or are applying for a child you can apply before the five year waiting period.
Who Is No Longer Eligible Under the New Law?
These categories of immigrant no longer eligible:
– People who came to the US as refugees.
– People granted asylum or withholding of removal (protection from being sent back to their home country);
– Survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act (VAWA);
– Survivors of human trafficking with a pending or approved T visa;
– People with Temporary Protected Status (TPS) and other visa holders (they already not able to get SNAP and Medicaid. Now also lose Medicare and ACA tax credits)
January 4, 2027: Immigrants Enrolled In Medicare Before July 4, 2025 Will Lose Coverage If They No Longer Meet Requirements
What This Means: Immigrants enrolled in Medicare before July 4, 2025, but don’t meet the new requirements, will lose their Medicare coverage beginning January 4, 2027.
Who Is Still Eligible Under the New Law?
- Green Card Holders (lawful permanent residents or LPR: A lawfully present immigrant is a non-citizen who is approved to live and/or work in the United States under U.S. immigration laws.)
- Certain Cuban and Haitian immigrants considered to be “Cuban and Haitian Entran” for benefits purposes under existing benefits law
- People from Palau, Micronesia, or the Marshall Islands who live in the U.S. under special agreements
- Lawfully residing children and pregnant adults in states that cover them under the Immigrant Children’s Health Improvement Act (ICHIA) option. If you are pregnant or are applying for a child you can apply before the five year waiting period.
Who Is No Longer Eligible Under the New Law?
These categories of immigrant no longer eligible:
– People who came to the US as refugees.
– People granted asylum or withholding of removal (protection from being sent back to their home country);
– Survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act (VAWA);
– Survivors of human trafficking with a pending or approved T visa;
– People with Temporary Protected Status (TPS) and other visa holders (they already not able to get SNAP and Medicaid. Now also lose Medicare and ACA tax credits)
Summary
The new law severely narrows which groups of immigrants qualify for Medicaid, Medicare, and Premium Tax Credits under the ACA. This takes away access to affordable health coverage for many low-income immigrants with lawful status. As a result, many immigrants will lose coverage they currently have. Others will no longer be able to apply.
Need assistance with enrolling for healthcare? Visit our friends at Palmetto Project for assistance today. Call (803) 779-4875 for Columbia office, or (843) 577-4122 for Charleston.
Thanks for reading. If you have questions, please feel free to email us at [email protected]. Stay tuned for more information on the ACA and healthcare changes ahead in our future blogs.
