Who is Eligible to Receive Medicaid?

Who is Eligible to Receive Medicaid?

Medicaid is a federal program managed by the states which, along with the Children’s Health Insurance Program (CHIP), provides health care coverage to over 72.5 million Americans, including children, pregnant women, fathers, seniors, and individuals with disabilities. 

This program is the country’s main source of health care coverage. Thirty percent of Medicaid's adult beneficiaries are Latinos, though numbers vary from state to state.

A study carried out by Unidos US in 2017 found that 36% of children enrolled in CHIP are Latinos.

In order for states to participate in Medicaid, federal law mandates that they provide coverage for certain groups of people. This includes low-income families, eligible pregnant women, and children, as well as individuals receiving Supplemental Security Income (SSI).

SSI is a cash benefit provided by Social Security to individuals with disabilities, such as the blind, seniors, and others who are unable to provide themselves with food and housing on their own. 

Medicaid covers a wide range of services, from medical and hospital services to vaccinations and maternal and infant care.

Each state has additional coverage options and can choose to cover additional groups, such as people receiving health care services at home or in community centers, or children in foster care.

In 2010, the Patient Protection and Affordable Care Act (ACA, also known as Obamacare) gave states the opportunity to expand Medicaid coverage to cover almost all low-income Americans under the age of 65. This meant that individuals earning wages slightly above the cut-off amount for eligibility could now qualify.

Most states chose to expand coverage to adults, and states that did not expand Medicaid can choose to do so at any time. 

According to a report from the Kaiser Family Foundation,  as of 2019 49 states cover children and families with income at least 200% below the federal poverty level or FPL (equivalent to $42,660 a year for a family of three) through Medicaid and CHIP.

The same report states that also since January of 2019, 32 states cover parents and other adults earning up to 138% of the FPL ($29,435 per year for a family of three and $17,236 per year for a single person) under the expansion of Medicaid.

Despite this expansion to cover over 70 million people since the ACA went into effect, the Hispanic population is still one of the most vulnerable groups when it comes to access to medical care.

You can enroll in Medicaid and CHIP at any time during the year. It’s important that you find information about the specific Medicaid program in your state because even if you didn’t qualify before, you may now be eligible under the new income requirements. 

Immigrants and Medicaid

All citizens who meet eligibility requirements, regardless of whether they were born in the US or are naturalized citizens, have the right to receive Medicaid or CHIP. 

Immigrants with a status defined as “qualifying non-citizens” are also generally eligible to receive coverage as well, as long as they meet income and residence guidelines for their state.

To obtain coverage under Medicaid or CHIP, many eligible non-citizens (such as those holding a green card) have a waiting period of 5 years. This means that they must wait 5 years before they can be considered as “eligible” immigrants before obtaining coverage under Medicaid or CHIP. However, states have the ability to reduce or eliminate this waiting period.

The term “eligible non-citizen” includes:

  • Permanent residents 
  • Individuals with asylum status
  • Refugees
  • Cubans  
  • Individuals who have been on parole for at least a year
  • Individuals who entered the country conditionally prior to 1980
  • Non-citizens who have been victims of domestic violence
  • Individuals who are applying for visas as human trafficking victims
  • An individual who is facing deportation and has been granted a grace period
  • Members of a federally recognized Native American tribe and Native Americans born in Canada

It is important to know that undocumented immigrants do not have the right to participate in these programs; however, some states have created local initiatives to cover them.

For example, California covers undocumented minors through Medi-Cal, the state’s version of Medicaid (including around 250,000 children and adolescents), and the state’s legislators are debating the possibility of also covering undocumented adults.

For families with mixed immigration statuses, it is important for parents to know that their children born in the United States are eligible for Medicaid or CHIP as long as the family meets eligibility requirements.

Recently, many families have not taken advantage of the services some members of their household have a right to receive due to a fear that their information will be shared with immigration authorities. 

This fear grew in 2018 when the Trump administration announced that it would strengthen a regulation known as “public charge,” so that individuals applying for their permanent residency or citizenship could have issues with their application if they had previously received government aid.

However, the Department of Health and Human Services’ website clearly states that: “Enrolling in Medicaid or CHIP, or the granting of subsidies to cover health insurance expenses on the insurance markets does not make anyone a ‘public charge.’” This means that it won’t harm your possibilities of becoming a legal permanent resident or citizen of the United States.

The HHS does state that there is one exception to this: “Individuals receiving long-term care in a government-funded institution may face barriers to receiving their green card.”

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