Medicaid and CHIP

Medicaid and CHIP

Wed, 02/12/2020 - 19:08
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Immigrants — Medicaid & CHIP

In general, immigrants who entered the U.S. on or after August 22, 1996 must wait five years after receiving qualified status before they are eligible for Medicaid or CHIP. Individuals not yet qualified may be eligible for emergency services and some may be eligible for insurance through the Marketplace.

♦ States have the option to adopt broader eligibility rules for immigrant children and pregnant women.

Immigrants who are “qualified non-citizens” are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules.

Medicaid & CHIP coverage for lawfully residing children and pregnant women

States have the option to provide Medicaid and CHIP coverage to lawfully present children and pregnant women.

♦ The term lawfully present includes all qualified immigrants, as well as many other types of immigrants who have permission to live or work in the United States.

States can use CHIP funding to provide prenatal care to women who are ineligible for Medicaid, without regard to immigration status.

Some states use state or county funds to provide Medicaid and CHIP to other groups, such as lawfully present immigrants who do not have qualified status and to children who are undocumented.

♦ States have the option to remove the 5-year waiting period.

A child or pregnant woman is lawfully residing if they’re lawfully present and otherwise eligible for Medicaid or CHIP in the state.

Twenty-nine states, plus the District of Columbia and the Commonwealth of the Northern Mariana Islands, have chosen to provide Medicaid coverage to lawfully residing children and pregnant women without a 5-year waiting period.

Twenty-one of these states also cover lawfully residing children or pregnant women in CHIP.

+ Find out if your state has this option in place.
State CHIP Medicaid
American Samoa***   Children and pregnant women
Arkansas Children Children and pregnant women*
California Children Children and pregnant women
Colorado Children and pregnant women Children and pregnant women*
Connecticut Children Children and pregnant women
Commonwealth of the Northern Mariana Islands (CNMI)   Children and pregnant women*
Washington, D.C.***   Children and pregnant women
Delaware Children Children and pregnant women
Florida Children Children*
Hawaii***   Children and pregnant women*
Illinois Children Children*
Iowa Children Children
Kentucky Children Children*
Louisiana Children Children*
Maine Children Children and pregnant women
Maryland***   Children and pregnant women
Massachusetts Children Children and pregnant women
Minnesota Children Children and pregnant women
Montana Children Children*
Nebraska Children Children and pregnant women*
New Jersey Children and pregnant women Children and pregnant women
New Mexico***   Children and pregnant women
New York Children Children and pregnant women
Nevada Children Children*
North Carolina Children Children and pregnant women*
Ohio***   Children and pregnant women
Oregon Children Children*
Pennsylvania Children Children and pregnant women
Rhode Island Children Children*
South Carolina   Children and pregnant women
Texas Children Children*
U.S. Virgin Islands***   Children and pregnant women
Utah Children Children*
Vermont***   Children and pregnant women
Virginia Pregnant women** Children Children and pregnant women*
Washington Children Children and pregnant women
West Virginia Children Children and pregnant women*
Wisconsin Children Children and pregnant women*
Wyoming   Pregnant women

Source:  Medicaid.gov — Updated as of December 11, 2019

* These States cover children in Medicaid up to age 19.

** Virginia is using an 1115 demonstration to cover pregnant women.

*** These states are CHIP Medicaid expansion programs.

Getting emergency care

Medicaid provides payment for treatment of an emergency medical condition for people who meet Medicaid eligibility criteria in the state, but don’t have an eligible immigration status.

Federal law prevents illegal immigrants from being covered by Medicaid. However, another law specifies that the poor cannot be turned away from emergency treatment.

  • Medicaid pays out about $2 billion a year for emergency treatment for people who show up at emergency rooms.

A portion of these people are homeless people but a much larger portion are illegal immigrants.

A hospital survey reports that most emergency Medicaid money goes to reimburse hospitals for the delivery of babies.

Medicaid, CHIP, and “public charge” status

Applying for Medicaid or CHIP, or getting savings for health insurance costs in the Marketplace, doesn’t make someone a public charge.

This means it won’t affect their chances of becoming a Lawful Permanent Resident or U.S. citizen.

However, people receiving long-term care in an institution at government expense may face barriers getting a green card.

Public charge means an individual who is likely to become primarily dependent on the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense.

♦ Starting from February 24, 2020 a new rule will be used to define "public charge."

The rule expands the list of publicly-funded programs that immigration officers may consider when deciding whether someone is likely to become a public charge.

Immigration officers will be given much more discretion when it comes to deciding if someone might become a public charge.

This topic is explained in much greater detail on the page Public Charge Rule

 

Source: Medicaid.gov, HealthCare.gov, CMS, HHS, USCIS