Last updated on: 8/24/2010 | Author:

Are undocumented immigrants covered in Obamacare?

General Reference (not clearly pro or con)

[Editors Note:  Public interest about whether or not undocumented immigrants would be covered under health care reform legislation began to grow in the summer of 2009.  This debate centered on an earlier version of health care reform legislation – HR 3200. (For a detailed policy review of the immigration provisions of HR 3200 see the Congressional Research Service report, “Treatment of Noncitizens in HR 3200“)

HR 3200 was never approved by the House.  It was superseded by a similar bill, “The Affordable Health Care for America Act” (HR 3962) which the House passed (220-215) in Nov. 2009.  Both of these earlier bills contained provisions that extended certain benefits to undocumented immigrants.  HR 3962 was finally reconciled with legislation passed by the Senate to become HR 3590.  When the bills were reconciled, the provisions that allowed undocumented immigrants to obtain benefits, such as the purchase of insurance through the insurance exchange, were removed.

The health care legislation that was finally passed and signed by President Obama on Mar. 23, 2010, “The Patient Protection and Affordable Care Act”  (HR 3590), explicitly denies any coverage or benefits to undocumented immigrants.  Its provisions are detailed by the “con” quotations presented below.]

PRO (yes)


[Editor’s Note: We have been unable to find any pros to this question, and if you know of any, please let us know. Aug. 23, 2010]

CON (no)


Kate Pickert, MA, staff writer for TIME magazine, stated in her July 19, 2010 article “What Will Joe Wilson Have to Say About Immigration Reform,” published in TIME magazine:

“Even after the Patient Protection and Affordable Care Act is fully implemented in 2019, about 23 million Americans will remain uninsured. About one-third of these will be undocumented immigrants, according to estimates by the Congressional Budget Office.

This is by design. Illegal immigrants will not be permitted to buy insurance through government-run exchanges even if they pay with their own money. They will not get federal subsidies to buy insurance and will remain ineligible for Medicaid and Medicare; and even legal immigrants will have to endure a five-year waiting period before they can sign up for Medicaid.”

July 19, 2010


The Social Security Administration stated the following in its Mar. 24, 2010 “Social Security Legislative Bulletin,” available at

“Health Care Affordability Tax Credits – Eligibility

Citizenship Status Verification

•  Requires the Exchanges, for purposes of preventing illegal immigrants from participating in an Exchange and obtaining premium tax credits and reduced cost sharing, to submit an applicant’s name, SSN, date of birth, and attestation of U.S. citizenship to the Secretary of HHS, who would, in turn, submit the information to SSA.

•  Requires SSA to determine whether an applicant’s name, SSN, date of birth, and allegation of U.S. citizenship are consistent with SSA records and report such determination to the Secretary of HHS.

•  Requires the Secretary of HHS to verify citizenship with the Department of Homeland Security (DHS), upon notification from SSA that it cannot confirm citizenship.

•  Requires such determinations to be made through the use of an online or electronic system developed by the Secretary of HHS, in consultation the Commissioner and DHS.

•  Requires, for any applicant whose claim of U.S. citizenship cannot be verified, the use of the citizenship verification procedures specified in section 1902(ee) of the Social Security Act. Such verification procedures require the State to make a reasonable effort to identify and address the causes of the inconsistent information and, after such efforts are made, the State must allow the individual 90 days to resolve the inconsistency with the Commissioner, or to present paper documentation of citizenship to the State.”

Mar. 24, 2010


The National Immigration Law Center stated the following in its Apr. 2010 publication “How Are Immigrants Included in Health Care Reform?,” available at


No federal coverage

• Not allowed to purchase private health insurance at full cost in state insurance exchange(s).

• Not eligible for premium tax credits or cost-sharing reductions.

• Exempt from individual mandate.

• Not eligible for Medicare, nonemergency Medicaid, or CHIP [Childrens Health Insurance Program].

• Remain eligible for emergency care under federal law.

• Eligible for Emergency Medicaid if low-income [this eligibility existed prior to passage of health reforms].”

Apr. 2010


James R. Edwards Jr., PhD, Fellow at the Center for Immigration Studies, stated the following in his July 2010 article “The Medicaid Costs of Legalizing Illegal Aliens,” available at

“The recently enacted health reform law, in part, expands eligibility for the Medicaid program. Illegal aliens remain ineligible for Medicaid beyond emergency services. However, this could change if they are legalized…

3.4 million uninsured illegal immigrants have incomes low enough (under 133 percent of poverty) to qualify for Medicaid under the expanded eligibility established by health reform…

The Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the Health Care and Education Reconciliation Act (P.L. 111-152), expands the Medicaid program to individuals and families with incomes up to 133 percent of the federal poverty level, including childless adults. One-third above the official poverty level equals $29,000 a year for a family of four…

Illegal immigrants are excluded from participating in welfare programs such as Medicaid (other than for emergency medical care). Were they to gain legal status through amnesty legislation, legalized aliens may be eligible for public programs, including Medicaid.”

July 2010