Understanding immigration status after health care reform legislation

What non-citizens would be provided with health care access after health care reform legislation (PPACA) was a particularly contentious issue. The debate resulted in a post health care reform system that will require complicated determinations based on the intricacies of immigration status. Understanding what non-citizens will qualify will have an impact on community health across the country as the non-citizen population in the United States has spread from the five traditional states of immigrant settlement to a majority of states. In the post reform system exchanges will be limited to non-citizens who are “lawfully present,” CHIPRA benefits to those who “lawfully residing” and full Medicaid to “qualified aliens.” A proposed interpretation of the term “lawfully present” by the Secretary of Health and Human Services raises more questions of meaning that need explanation. The Secretary included qualified aliens and thus legal permanent residents, refugees, asylees, aliens granted withholding, conditional entrants, Cuban/Haitian entrants, aliens paroled, and certain abused spouses and children. The Secretary also included among others, aliens in nonimmigrant status, or with temporary resident status or Temporary Protected Status, or employment authorization or in deferred action status or under deferred enforced departure, or with a certain approved visa petition or a pending asylum applicant or a pending Special Immigrant Juvenile application. This presentation will address what those terms mean in the specifics of immigration status and typical factual situations. It will also address what the post reform system means for those who cannot meet the status criteria.