Haris Ashley
Undocumented immigrants in the US face significant barriers to accessing health insurance and healthcare. As of 2023, about half of the undocumented immigrant population in the US has no health insurance, compared to less than 10% of naturalized citizens. Undocumented immigrants are not eligible for Medicaid or the Children's Health Insurance Program (CHIP), nor can they purchase coverage through the Affordable Care Act (ACA) Marketplaces. However, some states have expanded coverage for lawfully present immigrants and established fully state-funded programs to fill gaps in coverage for undocumented immigrants. Additionally, undocumented immigrants have the option to enroll in student health plans and individual plans purchased off-exchange. They also have access to certain healthcare services, regardless of their ability to pay, under the Emergency Medical Treatment & Labor Act (EMTALA).
| Characteristics | Values |
|---|---|
| Percentage of undocumented immigrants with health insurance | 50% |
| Percentage of undocumented immigrants without health insurance | 50% |
| Barriers to health insurance for undocumented immigrants | Limited access to private coverage, eligibility restrictions for federally-funded coverage options including Medicaid, CHIP, ACA Marketplace coverage, and Medicare, enrollment barriers such as fear, confusion about eligibility rules, and language access challenges |
| States with health insurance coverage for undocumented immigrants | Connecticut, Vermont, Colorado, Hawaii, California |
| Options for undocumented immigrants to obtain health insurance | Employer-provided insurance, student health plans, individual (non-group) plans purchased off-exchange, Medicaid in certain states, short-term insurance, ACA plans, Medicare in certain cases |
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What You'll Learn
- Undocumented immigrants can get health insurance through their employer
- Undocumented immigrants can buy non-group insurance
- Undocumented immigrants can enrol in student health plans
- Undocumented immigrants can get insurance through state-run exchanges
- Undocumented immigrants can access some healthcare services for free
Undocumented immigrants can get health insurance through their employer
Undocumented immigrants in the US face several challenges in accessing healthcare. They are more likely to be uninsured than citizens because they often work in jobs that do not provide health benefits. They also face eligibility restrictions for federally funded coverage options such as Medicaid, the Children's Health Insurance Program (CHIP), Affordable Care Act (ACA) Marketplace coverage, and Medicare. Even when eligible, they may face barriers to enrollment, including confusion about eligibility rules and language access challenges.
Despite these challenges, it is important to note that about half of the undocumented immigrant population has some form of health insurance coverage. This is primarily through employer-sponsored plans, but undocumented immigrants can also access health insurance through other means. For instance, some states are establishing programs that use state funds to subsidize health coverage for undocumented immigrants. For example, Connecticut's HUSKY (Medicaid/CHIP) program covers undocumented children up to age 12, and this will extend to age 15 starting in July 2024. Vermont has created the Immigrant Health Insurance Plan, which provides coverage to children under 19 and pregnant women who are not eligible for Medicaid due to their immigration status.
Additionally, undocumented immigrants can enroll in student health plans and individual (non-group) plans purchased off-exchange. They can also access certain safety-net programs, such as community health centers, which provide care regardless of insurance status or ability to pay.
In terms of legislative changes, California lawmakers are considering legislation that would allow undocumented immigrants to enroll in health insurance coverage in a manner similar to other Californians while adhering to federal rules. This could involve creating a separate platform, similar to the one established by Colorado. These discussions and proposals reflect a growing trend towards allowing undocumented immigrants to purchase coverage through a state-run exchange, either at full price or with state-funded subsidies.
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Undocumented immigrants can buy non-group insurance
Undocumented immigrants face many challenges in accessing healthcare in the US. They are more likely to be uninsured than citizens, due to their restricted access to private coverage and eligibility issues with federally-funded options. They also face language barriers, confusion, and immigration-related fears. Despite contributing billions in insurance premiums and taxes, they are less likely to use health care services, and so subsidize the US healthcare system.
Undocumented immigrants can also enroll in student health plans and individual (non-group) plans purchased off-exchange. On-exchange plans require proof of legal immigration status. They can also access short-term insurance, which is available at any time during the year and does not have to comply with certain federal market requirements for health insurance, such as the Affordable Care Act.
In New York, undocumented immigrants can get free or very low-cost insurance if they are pregnant and meet other requirements. They can also get Medicaid for emergency services if they meet the requirements.
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Undocumented immigrants can enrol in student health plans
Undocumented immigrants face several challenges when it comes to accessing healthcare in the United States. They are more likely to be uninsured than citizens due to limited access to private coverage and eligibility restrictions for federally funded programs such as Medicaid, the Children's Health Insurance Program (CHIP), Affordable Care Act (ACA) Marketplace coverage, and Medicare. Additionally, they may face barriers such as fear, confusion about eligibility rules, and language access challenges. Despite these challenges, some undocumented immigrants do have access to healthcare services through various avenues.
One option for undocumented immigrants to obtain health coverage is through student health plans. Undocumented immigrants can enrol in these plans, providing them with access to healthcare services while they are students. This is a significant step towards ensuring that this vulnerable population can access necessary healthcare services. It is important to note that undocumented immigrants may also have the option to enrol in individual plans purchased off-exchange, although on-exchange plans require proof of legal immigration status.
The Emergency Medical Treatment & Labor Act (EMTALA), a federal law, also ensures that anyone, regardless of insurance or residency status, can access emergency medical services. This law requires Medicare-participating hospitals to provide screening and stabilization services in their emergency rooms, ensuring that even those without insurance can receive critical care. However, as emergency rooms are typically the most expensive setting for healthcare, local officials often opt for less expensive alternatives.
While undocumented immigrants face significant challenges in accessing healthcare, there are some programs and policies in place to provide them with coverage. In addition to student health plans and EMTALA protections, a small but growing number of states have expanded fully state-funded coverage to certain groups of low-income individuals regardless of their immigration status. Additionally, the Biden administration has increased funding for Navigator programs that assist immigrant families in enrolling in health coverage, helping to address the challenges faced by this population in understanding and accessing available healthcare options.
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Undocumented immigrants can get insurance through state-run exchanges
Undocumented immigrants in the United States have limited health insurance options. They are not eligible for federal coverage subsidies and cannot use the Affordable Care Act (ACA) marketplaces to enrol in unsubsidized coverage. They also face eligibility restrictions for federally-funded coverage options, including Medicaid, the Children's Health Insurance Program (CHIP), ACA Marketplace coverage, and Medicare.
However, some states have taken steps to expand access to health insurance for undocumented immigrants. For example, in 2022, Vermont created the Immigrant Health Insurance Plan, which provides health coverage to children under 19 and pregnant women who are not eligible for Medicaid due to their immigration status. Starting in 2025, Colorado will provide Medicaid coverage to undocumented pregnant people and children who would otherwise be eligible based on income. Other states, such as California and Maryland, are considering similar legislation to allow undocumented immigrants to purchase coverage through state-run exchanges, either at full price or with state-funded subsidies.
Colorado's program, OmniSalud, allows undocumented immigrants to apply for health insurance through a state-run shopping platform separate from the state's ACA marketplace. Accompanying state subsidies significantly reduce the cost of coverage, but availability is limited. In 2023, funding enabled 10,000 undocumented Coloradans with incomes up to 150% of the federal poverty level to enrol in a plan with no monthly premium and substantial cost-sharing assistance.
Undocumented immigrants can also enrol in student health plans and individual (non-group) plans purchased off-exchange. Additionally, they have access to certain healthcare services, regardless of their ability to pay, due to the Emergency Medical Treatment & Labor Act (EMTALA), a federal law that requires Medicare-participating hospitals to provide screening and stabilization services for anyone who enters their emergency rooms, without regard for insurance or residency status.
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Undocumented immigrants can access some healthcare services for free
Undocumented immigrants in the US face several challenges in accessing healthcare services. They are more likely to be uninsured than citizens due to limited access to private coverage and eligibility restrictions for federally-funded programs such as Medicaid, the Children's Health Insurance Program (CHIP), Affordable Care Act (ACA) Marketplace coverage, and Medicare. Despite these barriers, there are some options for undocumented immigrants to access healthcare services for free or at a low cost.
Firstly, emergency services are available to undocumented immigrants through the Emergency Medical Treatment and Labor Act (EMTALA). EMTALA ensures that all patients, regardless of citizenship or immigration status, have access to emergency medical treatment in hospital emergency rooms. The costs of these services are often covered by emergency Medicaid, which provides funding for hospitals, physicians, and ambulance services. This is particularly important for undocumented immigrants, as they are generally ineligible for regular Medicaid coverage due to their immigration status.
In certain states, undocumented immigrants may also be eligible for state-specific benefits. For example, as of April 2025, 14 states and Washington, D.C., provide comprehensive state-funded healthcare coverage to children regardless of their immigration status. These states include California, Colorado, Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island, Utah, Vermont, and Washington.
Additionally, undocumented immigrants with sufficient income can purchase private health insurance, although they are not eligible for federal subsidies. They may also be able to access insurance through their employers or obtain limited primary care and prescription drugs through Federally Qualified Health Centers (FQHCs) located across the country.
While undocumented immigrants face significant barriers to healthcare access, these options provide some avenues for them to receive necessary medical care without incurring high costs. However, it is important to note that these options may not provide comprehensive or long-term healthcare solutions, and further efforts are needed to address the unique challenges faced by this population in accessing healthcare services.
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Frequently asked questions
As of 2023, 50% of undocumented immigrant adults reported being uninsured.
Undocumented immigrants face barriers to accessing healthcare, such as higher uninsured rates, language access challenges, confusion, and immigration-related fears.
Undocumented immigrants have a few options for health insurance, including employer-provided insurance, student health plans, and individual (non-group) plans purchased off-exchange. Some states, like Vermont, have created programs to provide health coverage to undocumented immigrants.
Undocumented immigrants are not eligible for Medicaid due to their immigration status. However, some states, like Connecticut and Vermont, have programs that provide health coverage to undocumented children and pregnant women who don't qualify for Medicaid.
You can apply for health insurance by calling (800) 300-1506 or with a certified enroller or your county. You can also explore options like short-term insurance or Medicaid, which can be enrolled in at any time during the year.
