Uphill Battle for Immigrants to get Insurance

/, Health Insurance and Reform, Medicaid & CHIP/Uphill Battle for Immigrants to get Insurance
Melissa McChesney

Last week we discussed how confusion about eligibility and fear can keep immigrants from accessing the affordable coverage now available to them through the Affordable Care Act (ACA). This week we will look at common technical hurdles immigrants must overcome when they do attempt to enroll in affordable coverage in the Marketplace. Many immigrants may face one or all of these hurdles, and the process for enrolling in Marketplace coverage can takes weeks to finalize.

Verification of Identity and Immigration Status

The first step to enrolling in coverage through the Marketplace is to create a Healthcare.gov account. In order to do this, consumers must verify their identity. Healthcare.gov relies on credit histories to automatically verify identity, which can present a stumbling block for recent immigrants. If a consumer cannot verify her identity online, she can follow up with the Healthcare.gov call center and try to verify her identity over the phone. This process is often unsuccessful for people with little or no U.S credit history. In the end, many individuals are asked to submit paper documentation. .

Likewise, verification of immigration status can also be a slow and arduous process. Healthcare.gov will attempt to use electronic data to verify immigration status, but this process is often unsuccessful and paper documentation will be requested. The Marketplace will allow individuals to enroll in coverage pending verification of those documents, however, coverage will be cancelled if they haven’t submitted the required paperwork within 90 days. But this process can be confusing and many individuals have had to submit paperwork more than once. From April to June of 2015, 306,000 people across the U.S. lost Marketplace coverage because of a citizenship or immigration status data matching issues.

Experts advise that scanning and uploading documents electronically, as opposed to mailing paper copies, will result in faster processing. Find more tips on how to resolve inconsistencies in immigration verification here.

Incorrect Assessments of Medicaid eligibility can delay processing

Another delay in processing applications from immigrants can occur when the Marketplace incorrectly identifies a lawfully permanent resident as potentially eligible for Medicaid or falling in the Coverage Gap.

In Texas, almost all lawfully present immigrant adults are excluded from Medicaid as a state-government policy. Federal law protects legal immigrants excluded from Medicaid due to their citizenship status by allowing them to access Marketplace subsidies even when they have below-poverty incomes. Therefore, most legal immigrant adults earning under 400 percent of the federal poverty level are eligible to purchase Marketplace coverage and receive subsidies.

Immigrants incorrectly identified by the Marketplace as potentially Medicaid eligible must wait to receive a formal Medicaid denial from the Texas Health and Human Services Commission before they can move forward with their application at Healthcare.gov. This slows the enrollment process yet again.

More help with these issues

The Center on Budget and Policy Priorities has created a detailed tip sheet for individuals assisting immigrant consumers with Marketplace enrollment.  This is a great reference, and includes a number of important best practices that can reduce the impact of the barriers identified above.

Read all the posts in our 2016 Countdown to Coverage series.

At the Center for Public Policy Priorities, we believe in a Texas that offers everyone the chance to compete and succeed in life. We envision a Texas where everyone is healthy, well-educated, and financially secure. We want the best Texas - a proud state that sets the bar nationally by expanding opportunity for all. CPPP is an independent public policy organization that uses data and analysis to advocate for solutions that enable Texans of all backgrounds to reach their full potential. We dare Texas to be the best state for hard-working people and their families.

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