Last Friday U.S. Immigration and Customs Enforcement (ICE) issued a clarification stressing that information provided by those applying for insurance under the Affordable Care Act will not trigger immigration enforcement. Undocumented immigrants are not eligible for health care under the Affordable Care Act (ACA); however, this clarification should bring peace of mind to mixed-status families. Eligible members of those families will now be able to seek coverage under the ACA without fear of placing some family member at risk of deportation.
As part of its goals, the ACA aims to increase the quality of health insurance by reducing the costs of health care for individuals and the government. It encompasses a number of mechanisms, such as requiring individuals not covered by an employment-sponsored health plan, Medicaid, or Medicare to obtain an approved insurance policy (individual mandates); providing subsidies to help low income people comply with the mandate; and establishing health insurance marketplaces where individuals and small business can compare policies and buy insurance.
Among immigrants, only naturalized citizens have full access to the ACA. Lawful permanent residents (LPR) are eligible for federal coverage, but with some limitations. Undocumented immigrants, on the other hand, are not allowed to purchase insurance in the exchanges and are not eligible for premium tax credits, lower copayments, Medicaid, or the Children’s Health Insurance Program (CHIP), among other exclusions. However, they are also exempt from the individual mandate.
Some families have members of varying legal status (for example, citizen and non-citizen parents and children, or family members with any combination of legal status), so members in one household may be eligible for certain public benefits (including some ACA benefits) while others in the family are barred from them. In this context, ICE’s clarification is reassuring and hopefully will be instrumental in ensuring that anyone who is eligible for health insurance coverage can actually access it. Specifically, ICE’s announcement states that
“In line with ICE’s operational focus, ICE does not use information about such individuals or members of their household that is obtained for purposes of determining eligibility for such coverage as the basis for pursuing a civil immigration enforcement action against such individuals or members of their household, whether that information is provided by a federal agency to the Department of Homeland Security for purposes of verifying immigration status information or whether the information is provided to ICE by another source.”
This clarification is important in more than one way. Directly, it guarantees U.S. citizens who are part of mixed status families the ability to apply for healthcare. Indirectly, it also helps build trust between the immigrant community and government agencies. This is not a trivial point, considering that higher levels of trust are usually linked to more effective policy implementation.