Undocumented aliens 1. Can only get emergency benefits. In this report, the group labeled "not qualified" includes the PRUCOL immigrants, while undocumented aliens are reported separately. More complete definitions of each category are provided in Table 2 of the report. Only a small share of the pre-enactment i. The main effects are for post-enactment i. Because of changes in the rules for "deeming" income, a large fraction perhaps most of the immigrants will still be ineligible after five years expires.
In determining eligibility, the income of those who sponsored immigrants will be deemed available to them, making it more difficult for immigrants to qualify as sufficiently poor. Those in the U. However, the elderly and disabled immigrants arriving after August will not qualify for SSI or Medicaid unless they become citizens or meet other exemptions. In general, the immigrant-related rules no longer apply for those immigrants who naturalize into U.
The discussion above describes the basic federal rules under welfare reform. States have leeway to customize rules. Wyoming, for example, has elected to extend the bar on Medicaid participation to immigrants who entered the U.
Texas has announced that it intends to continue to extend the bar for post-enactment immigrants beyond five years, until they become citizens. Other states, such as Washington and Hawaii, have chosen to partially protect immigrants, using state funds to cover some benefits lost under the federal law. Although California's governor proposed changing the rules to match the basic federal guidelines, the legislature did not enact these changes.
Thus, prior state eligibility rules still apply. The governor will probably propose these changes again in , so that the policies may change in the future. It seems likely that the federal government will not match state expenditures for non-emergency care provided to post-enactment immigrants in California, but there are a number of technical issues that still need to be resolved in determining state and federal shares. Future Scope. The QC data for are useful if we assume that the distribution of immigrant categories in post-enactment years mirrors that in and that most states adopt policies close to the basic federal guidelines.
With this assumption, about 5 percent of Medicaid enrollees would not be eligible for full benefits in their first five years because they are "regular" legal immigrants or are in the "not qualified" group. State Estimates. The distribution of immigrants varies widely across the states. California had the most noncitizens, about one quarter 25 percent of its caseload. Indeed, the 1. Immigrants are highly concentrated: these 10 states include 91 percent of the nation's total number of Medicaid immigrants and account for 90 percent of the nation's expenditures for immigrants.
In 21 states, less than 1 percent of the Medicaid enrollees were immigrants. Medicaid Expenditures for Immigrants. Are Medicaid expenditures for immigrants different than for citizens? If the individual cannot provide Form I, contact DHS to verify status and length of the parole period before certification. Derive the date status granted from the date on Form I, the grant letter or the date of the court order. If the date is missing from Form I, request the grant letter from the alien.
If it is not available, verify the date status was granted with DHS. However, the date of the form does not reflect when the status was granted. Request Form I, the grant letter from the Asylum Office of DHS or the alien's copy of a court order of the immigration judge granting asylum to obtain the date status was granted.
Verify with DHS if none of these are available. If the alien alleges having been granted asylum within the previous seven years, contact DHS using Form G and Form G supplement with a copy of Form I attached. Request the alien's copy of the court order to obtain the date of withholding.
If not available, verify with DHS. Note: Aliens who have been granted a suspension of deportation are not eligible for Medicaid benefits on the basis of that status alone. The description and annotations on the DHS documents must be as shown above in order to establish eligibility based on withholding of deportation or removal. An alien could meet more than one classification.
An alien who has been, or whose child or parent has been, battered or subjected to extreme cruelty in the United States by a U. Unless the spouse files this petition, the alien and children have no lawful immigrant status and face being deported. Since the enactment of the Violence Against Women Act, a battered alien may self-petition for lawful permanent residency via INS Form I, Petition for Amerasian, Widow er or Special Immigrant, without the cooperation or knowledge of the abuser.
Qualified aliens with a battered alien status do not need to be credited with 40 qualifying quarters of Social Security coverage nor do they have a seven-year limited eligibility period. The following battered aliens meet the alien status criteria if they:. Consider Medicaid for the treatment of an emergency condition when the battered alien does not meet alien status criteria.
The U. Department of Health and Human Services certifies individuals who meet the victims of severe human trafficking requirements so they may remain in the U. Law enforcement authorities can extend the status beyond four years for individuals whose presence is required for a continuing investigation. These individuals meet the alien status criteria to be potentially eligible for benefits without a five-year waiting period and continue to meet the eligibility criteria without a limited eligibility period as long as the law enforcement extension continues, or they adjust to another acceptable alien status.
SAVE does not provide verification for victims of trafficking. Staff must call the trafficking verification toll-free number at to confirm the validity of the USCIS extension letter. After four years or expiration of a law enforcement extension, individuals who have not adjusted to another alien status must leave the U.
If they remain, they are considered undocumented and ineligible for ongoing benefits. When SAVE does not contain information about victims of severe trafficking or non-alien family members, call the trafficking verification toll-free number at to confirm the validity of the certification letter or Derivative T Visa and to notify the Office of Refugee Resettlement of the benefits for which the individual is applying.
Supervisors complete and route Form , Request for Applications and System Access, to the regional security officer for employees who need access to the SAVE system. Note: Staff should enter the correct alien number as listed on the document, not a default or fictitious number for example, AAA, etc.
The list displays the Case Status for cases that require action, cases in process and closed cases. Click the Verification Number to view the Case Details. The user is able to print the case details, request additional verification and close the case. If the system is unable to verify the immigration status with the information provided by the user in the automated additional verification request, or the document appears counterfeit, altered or expired, use the manual process in Section D , Secondary Verification of Alien Immigration Status.
If staff are unable to verify an alien's immigration status through primary verification procedures, use SAVE to request additional information from the U.
Once a request from USCIS is obtained for verification of immigration status, the information received must be processed. If the information entered can be verified on the 1st Level Verification, staff will see the alien status, category code, and entry date. If you are unable to verify an alien's immigration status through primary or secondary verification procedures, allow the applicant a reasonable opportunity of 95 days following the date on which a notice is sent to an individual to provide another source of citizenship or alien status verification.
Unless the alien meets the criteria in Section D, consider Medicaid for the treatment of an emergency medical condition. Note: Follow your policy clearance request procedures for questions about documents or immigration statuses not listed in this chart. If less than seven years have passed since the date of qualified alien classification, usually the entry date, then the alien is eligible if the alien meets the criteria in Section D , Qualified Aliens Subject to a Seven-Year Limited Period.
Note: Victims of Severe Human Trafficking are limited to four years unless status is extended by law enforcement. If seven years or more have passed from the date of qualified alien classification, usually the entry date, then the alien is eligible if the alien meets the criteria in Section D , Qualified Aliens Not Subject to a Waiting Period or Limited Period. Note: The refugee retains this eligibility period even if the refugee has adjusted to lawful permanent resident LPR status during the seven-year limited period.
For those special immigrants who are adjusting their status to LPR status in the U. Note: The entry date for an Afghani special immigrant must be Dec. An Iraqi special immigrant's entry date must be Jan.
Note: The special immigrant retains this eligibility period even if the special immigrant has adjusted to lawful permanent resident LPR status during the seven-year limited period. Note: Follow your policy clearance request procedures for questions about documents or immigration statues not listed in this chart.
If five years or less have passed since the date of qualified alien classification, usually the entry date, then the LPR alien is not eligible. Unless the alien meets criteria other than 40 qualifying quarters in Section D , Qualified Aliens Not Subject to a Waiting Period or Limited Period, the LPR alien is only potentially eligible for Medicaid for the treatment of an emergency medical condition during the five-year waiting period.
Having 40 qualifying quarters does not exempt a person from the five-year waiting period. If more than five years have passed since the date of qualified alien classification, usually the entry date, then the LPR alien is eligible if the LPR alien meets the criteria in Section D Unless the LPR alien meets the criteria in Section D, consider Medicaid for the treatment of an emergency medical condition.
Follow your policy clearance request procedures for questions about documents or immigration statuses not listed in this chart. D, Alien Status. Citizenship and Qualified Alien Status. D Groups of Aliens Revision ; Effective December 1, For Medicaid eligibility purposes, an alien is any person who is not a natural-born or naturalized citizen or national of the U. Generally, aliens are now referred to as: qualified aliens; or non-qualified aliens.
Verifying continuous presence DHS maintains a record of arrivals to and departures from the country for most legal entrants.
Asylees under Section of the INA. If a person is an "Amerasian immigrant" and meets no other condition permitting eligibility, then the person is potentially eligible for Medicaid for seven years beginning with the date "Amerasian immigrant" status was granted.
Afghan and Iraqi special immigrants eligible for resettlement assistance, federal benefits and entitlements. D Qualified Aliens Not Subject to a Waiting Period or Limited Period Revision ; Effective September 1, Certain aliens are exempt from both the five-year waiting period and the seven-year limited period when they meet certain criteria. The following aliens are eligible for full Medicaid and or MSP if they meet all other eligibility criteria: honorably discharged veterans or active duty members of the U.
Start the Clock — The clock on the five-year waiting period begins to run from the date the person: enters the U. Stop the Clock — The clock stops: with the beginning of the first month after the fifth anniversary of the date the person obtains the qualified alien classification, or earlier than the fifth anniversary if: the alien classification changes and the alien meets criteria in Section D, or the alien meets one of the LAPR conditions in Section D Be credited with 40 qualifying quarters of Social Security coverage.
Meet an alien classification criterion in Section D if the clock for the seven years has not ended. Count the spouse's quarters earned during the marriage when the spouse is either a citizen or an alien and any of the following conditions apply: The couple is currently married. A spouse is deceased and the surviving spouse has not remarried. Share this page on:. Eligibility group.
Federal statutory and regulatory requirements. State plan options. In , Congress established a new category of noncitizens — survivors of trafficking — who are eligible for federal public benefits to the same extent as refugees, regardless of whether they have a qualified immigrant status. In , the U. Department of Health and Human Services HHS published a notice clarifying which of its programs fall under the definition.
Any new programs must be designated as federal public benefits in order to trigger the associated eligibility restrictions and, until they are designated as such, should remain open to broader groups of immigrants. The HHS notice clarifies that not every benefit or service provided within these programs is a federal public benefit.
The welfare law also attempted to force states to pass additional laws, after August 22, , if they choose to provide state public benefits to certain immigrants. The law includes important exceptions for certain types of services.
School breakfast and lunch programs remain open to all children regardless of immigration status, and every state has opted to provide access to the Special Supplemental Nutrition Program for Women, Infants and Children WIC. Short-term noncash emergency disaster assistance remains available without regard to immigration status. Also exempted from the restrictions are other in-kind services necessary to protect life or safety, as long as no individual or household income qualification is required.
When a federal agency designates a program as a federal public benefit foreclosed to not-qualified immigrants, the law requires the state or local agency to verify the immigration and citizenship status of all program applicants. However, many federal agencies have not specified which of their programs provide federal public benefits. Until they do, state and local agencies that administer the programs are not obligated to verify the immigration status of people who apply for them.
Congress restricted eligibility even for many qualified immigrants by arbitrarily distinguishing between those who entered the U. The law barred most immigrants who entered the U. In addition, children who receive federal foster care and COFA migrants are exempt from the five-year bar in the Medicaid program.
The District of Columbia, New Jersey, and New York provide prenatal care to women regardless of immigration status, using state or local funds. Although the federal health care reform law, known as the Affordable Care Act ACA , [31] did not alter immigrant eligibility for Medicaid or CHIP, it provided new pathways for lawfully present immigrants to obtain health insurance.
Although the law severely restricted immigrant eligibility for the Supplemental Nutrition Assistance Program SNAP, formerly known as the Food Stamp Program , subsequent legislation restored access for many immigrants. Other qualified immigrant adults, however, must wait until they have been in qualified status for five years before they can secure critical nutrition assistance.
Six states — California, Connecticut, Illinois, Maine, Minnesota, and Washington — provide state-funded nutrition assistance to some or all of the immigrants who were rendered ineligible for the federal SNAP program. Congress imposed its harshest restrictions on immigrant seniors and immigrants with disabilities who seek assistance under the SSI program.
For example, SSI continues to exclude not-qualified immigrants who were not already receiving the benefits, as well as most qualified immigrants who entered the country after the welfare law passed and seniors without disabilities who were in the U.
The main rationale for the seven-year time limit was that it was intended to provide a sufficient opportunity for humanitarian immigrant seniors and those with disabilities to naturalize and retain their eligibility for SSI as U. However, a combination of factors, including immigration backlogs, processing delays, former statutory caps on the number of asylees who can adjust their immigration status, language barriers, and other obstacles, made it impossible for many of these individuals to naturalize within seven years.
Although Congress enacted an extension of eligibility for refugees who faced a loss of benefits due to the seven-year time limit in , that extension expired in Five states — California, Hawaii, Illinois, Maine, and New Hampshire — provide cash assistance to certain immigrant seniors and people with disabilities who were rendered ineligible for SSI; some others provide much smaller general assistance grants to these immigrants.
Under the welfare and immigration laws, family members and some employers eligible to file a petition to help a person immigrate must become financial sponsors of the immigrant by signing a contract with the government an affidavit of support. Under the enforceable affidavit Form I , the sponsor promises to support the immigrant and to repay certain benefits that the immigrant may use. Congress imposed additional eligibility restrictions on immigrants whose sponsors sign an enforceable affidavit of support.
The laws imposed deeming rules in certain programs until the immigrant becomes a citizen or secures credit for 40 quarters approximately 10 years of work history in the U. Department of Agriculture USDA has issued helpful guidance on the indigence exemption and other deeming and liability issues.
Confusion about eligibility rules pervades benefit agencies and immigrant communities. The confusion stems from the complex interaction of the immigration and welfare laws, differences in eligibility criteria for various state and federal programs, and a lack of adequate training on the rules as clarified by federal agencies.
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