Can legal immigrants receive Medi-Cal benefits or apply for a CoveredCA health plan?

The answer is — it depends. Let’s explore this topic in detail.

Diana Polyakov
Oct 5 · 7 min read

Quite frankly this is a very confusing question. In order to understand it fully it is wise to note that there are different classifications of immigrants and there are certain limitations to each group of immigrants. So, for example, there are individuals that are not lawfully present in the USA or undocumented individuals and there those who are lawfully present. Undocumented individuals are typically not even eligible for any of the benefits offered in the US. Further, those who are lawfully present might be eligible for certain benefits, but there are rules that need to be strictly followed.

Let’s see who is considered lawfully present individuals?

Lawfully present individuals in the United States generally include:

  • U.S. citizens and U.S. nationals.
  • Lawful permanent residents or (“green card holders”).
  • Lawful temporary residents.
  • Persons fleeing persecution, including refugees and asylees.
  • Other humanitarian immigrants, including those granted temporary protected status.
  • Non-immigrant Status holders (including worker visas and student visas).

By law, only those who are lawfully present might be eligible for certain benefits, but certain groups (for example those who have a Green Card) can’t get any benefits until they have resided as a legal resident for five years (in certain cases).

We will skip the U.S. citizens and U.S. nationals for the purpose of this topic- and let’s talk about the lawfully present individuals and see whether or not they are eligible for any public benefits?

LPRs — sometimes referred to as green card holders — do not have full access to all public benefit programs and are subject to limitations before being eligible for federal means-tested benefits, including Medicaid, (Medi-Cal in California), the Children’s Health Insurance Program (CHIP), TANF, SNAP, and SSI. Such limitations include the “five-year bar,” which requires the individual to have maintained LPR status in the U.S. for five years before being eligible for benefits.

Certain additional categories of immigrants, specifically refugees, asylum seekers, and victims of human trafficking or domestic violence have the same eligibility requirements for federal benefits as LPRs. Individuals on non-immigrant and temporary visa holders are ineligible for benefits, and they have to fully support their stay and cover medical expenses on their own. (You can read more about healthcare options for new immigrants to the U.S.)

But this is not news. The Immigration Law prohibited or limited new immigrant’s access to public benefits since the early 1800’s. So what’s this all buzz all about?

Well, there has been a Proposed Change to Public Charge Ground of Inadmissibility, which was recently published in the Federal Register.

If finalized, this rule “would enable the federal government to better carry out provisions of U.S. immigration law related to the public charge ground of inadmissibility. This proposed rule would change the standard that is used when determining whether an alien is likely at any time in the future to become a public charge, and is therefore inadmissible under section 212(a)(4) of the INA, ineligible for adjustment of status, or ineligible for admission or a visa. The rule would also make nonimmigrant aliens who are public charges generally ineligible for change of status and extension of stay. USCIS believes this proposal is more consistent with Congressional intent regarding the public charge ground of inadmissibility. “ (source United States Citizenship and Immigration Services)

WHAT HAPPENS IF YOU SPONSOR YOUR PARENTS TO COME TO THE US?

Let’s take a look at a scenario:

Let’s say that you are a U.S. Citizen and would like to file an immigration petition for your parents who live in a foreign country so they can live with you in the USA and get their Green Cards. When you apply for their Green Cards, you have to sign an immigration form that is called Affidavit of Support. This form is basically a contract between you and the U.S. Government.

By signing this form, you have to prove that you (as a sponsor) have enough income and/or assets to maintain the intended immigrants and the rest of your household. Under this contract, you agree that you will support your relatives and they will not become a public charge.

If your parents apply for Medi-Cal or other “means-tested benefits” you (as a sponsor) are responsible for repaying the cost of those benefits to the agency that provided them. If you do not repay the debt, the agency can sue you in court to get the money owed to them. So, honestly the consequence could be quite severe for the sponsor in this case (if the sponsor fails to support the immigrant relative and the relative eventually gets the “means-tested benefits”

As you can see, even though by law new immigrants are not allowed to apply for benefits, some do apply and get it. The questions is — what to expect next? What are the consequences?

So, let’s revise the question:

Can Immigrants Whose Sponsor Signed an Enforceable Affidavit Get Benefits?

The answer is Yes, they can. In California, immigrants whose sponsors sign enforceable affidavits can get benefits. However, their sponsor’s income may be added to theirs (“deemed” as theirs) when they apply for certain benefits, such as Medi-Cal, CalWORKs, CAPI, and food stamps. If the income was reported incorrectly or the application was filed incorrectly, then obviously there could be consequences, and the sponsor has to pay back all the money to the agency that provided those benefits (see above)

Why Does the Sponsor’s Income Count When the Immigrant Applies for Medi-Cal?

Under “immigrant sponsor deeming,” the income and resources of the immigrant’s sponsor are considered, or “deemed,” to be available to the sponsored immigrant when he or she applies for certain public benefits. Deeming rules usually make the immigrant ineligible for benefits because adding the sponsor’s income and resources renders the immigrant “over-income.” There are exceptions to the deeming rules — for example, for domestic violence victims or immigrants who would go hungry or homeless without assistance.

Which Public Benefits are considered “means-tested benefits” and will need to be repaid?

Sponsors who sign enforceable affidavits of support (Form I-864) may need to repay “means-tested public benefits” used by the immigrant after he or she becomes a lawful permanent resident.

The only federal benefits that are considered “means tested” are:

  • Supplemental Security Income (SSI),
  • Food stamps,
  • CalWORKs,
  • Medi-Cal
  • Healthy Families

Do the same rules apply for benefits available via CoveredCA?

Notice, that subsidized health plans (provided via CoveredCA) are not on the list above of “means-tested benefits”. Well, that is because CoveredCa is not a public benefit. CoveredCA is a platform where people can get private health insurance plans at a lower cost in California. Subsidies available via CoveredCA are strictly based on taxable income. So, if the new immigrants apply for subsidized health plans via CoveredCA they will not have to re-pay it back as long as the income included on the application is correctly entered. Well, it makes sense if the immigrant is working and paying taxes, they can access the tax subsidies available via CoveredCa.

U.S. citizens, U.S. nationals and lawfully present individuals who meet all other eligibility requirements, such as California state residency, may be eligible to purchase a health insurance plan through Covered California and may be eligible for financial assistance (tax credit or subsidy).

Annual household income is calculated by the income of the taxpayer, the taxpayer’s spouse (if any) and any child or dependent of the taxpayer who is required to file a tax return. Individuals who have not filed federal taxes in the past may still be eligible for financial assistance, but they must agree to file taxes for the upcoming tax year (under a Social Security number or an Individual Taxpayer Identification Number [ITIN]).

For lawful permanent residents who are seeking health insurance coverage through Covered California there is no “waiting period” or “five-year bar.”

Individuals who are under Deferred Action for Childhood Arrivals (DACA) are not considered lawfully present. They are not eligible to purchase a Covered California health plan or receive financial assistance.

Legal Disclosure:

Please note that the information presented in this article does not constitute legal advice. If you are confused or not sure how to interpret the above information, please consult with an Immigration Attorney.

PROPOSED CHANGE TO PUBLIC CHARGE GROUND OF INADMISSIBILITY

The Law:

Section 212(a)(4) of the INA: Any alien who, in the opinion of the consular officer at the time of application for a visa, or in the opinion of the Attorney General at the time of application for admission or adjustment of status, is likely at any time to become a public charge is inadmissible[…] In determining whether an alien is excludable under this paragraph, the consular officer or the Attorney General shall at a minimum consider the alien’s-(I) age; (II) health; (III) family status; (IV) assets, resources, and financial status; and (V) education and skills . . . .”

8 U.S.C. § 1601 (PDF)(1): “Self-sufficiency has been a basic principle of United States immigration law since this country’s earliest immigration statutes.”

8 U.S.C. § 1601 (PDF)(2)(A): “It continues to be the immigration of the United States that aliens within the Nation’s borders not depend on public resources to meet their needs, but rather rely on their own capabilities and the resources of their families, their sponsors, and private organizations.”

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