The Affordable Care Act Includes Legal Immigrants

By Marie Yeung
Marie Yeung
Marie Yeung
December 20, 2013 Updated: December 19, 2013

Immigrants who are not citizens will find it easier to get health insurance coverage because of the federal health reform law, according to a study by the George Washington University School of Public Health and Health Services (SPHHS).

“Traditionally, we have for various ways made it harder for non-citizens, that is immigrants that have not been yet naturalized, to get health insurance coverage,” said Leighton Ku, Ph.D., MPH, author of the new report and director of the Center for Health Policy Research at SPHHS in a telephone interview. 

“This provides many better opportunities, particularly increasing access in private health insurance coverage which is where the biggest problems are for the 6 million legal immigrants in our nation.”

Good for Providers to Immigrants

Under the Affordable Care Act (ACA), legal immigrants can now sign up for Medicaid in the states that have chosen to expand their Medicaid programs, as long as they meet income and other requirements. 

According to Ku, this increases the likelihood that health centers, clinics, or hospitals that serve immigrant Latino, Asian, and African populations will be willing to provide those groups services. More of those groups will have health insurance, so the providers will be reimbursed or paid directly.


Ku said that some areas face shortages of health professionals and the wider insurance coverage of the ACA could add to these problems. The situation will vary from place to place. “In Texas, about two-thirds of the state is considered a health professional shortage area, and there are at least a couple dozen counties that don’t have any doctors in them at all.”

Another problem that health care providers might face is that only a limited number of them have the right language skills to serve some immigrants. 

“We have heard certain community health centers that deal with a large number of immigrant patients are currently building up staff right now because they are expected to see more patients.” 

Mandates Apply to Immigrants

The individual insurance mandate will also apply to immigrants. They will have to have health insurance or pay a tax penalty.

“Some people might not be able to afford health insurance, so for people who are very poor there are exemptions that exist. Undocumented immigrants are exempt as the federal government has decided they aren’t getting assistance with health so it isn’t fair to penalize them,” added Ku.

Marie Yeung