1. Immigration Basics & Overview of Health Benefit Eligibility for Non-U.S. Citizens Law Offices of Manuela M. Morais

2. USEFUL ACRONYMS  LPR- Lawful Permanent Resident or “green card” holder  USC- U.S. Citizen  EWI- Entry Without Inspection, i.e. undocumented  DHS- Department of Homeland Security  ICE- Immigration and Customs Enforcement  CBP- Customs and Border Protection  USCIS- U.S. Citizenship and Immigration Services  EOIR- Executive Office of Immigration Review or “Immigration Court”

3. FALSE ASSUMPTIONS regarding eligibility for health benefits  Non-citizens are ineligible  Persons without Social Security Numbers (SSNs) are ineligible  Non-LPRs are ineligible  All LPRs are eligible

4. COMMON CATEGORIES OF LAWFUL STATUS  LPR  Asylee  Refugee  Temporary Protected Status  Cuban/Haitian Entrant  Paroled into the U.S.  Battered Spouse, Child and Parent  Victim of Trafficking and his/her Spouse, Child, Sibling or Parent  Granted Withholding of Removal or protection under the Convention against Torture (CAT)  Non-immigrant worker visas (such as H1, H-2A, H-2B), student visas, U-visa, T-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau  Deferred Action Status (Exception: Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying for health insurance)  Administrative order staying removal issued by the Department of Homeland Security  Member of a federally-recognized Indian tribe or American Indian Born in Canada  Resident of American Samoa  Special Immigrant Juvenile Status  Adjustment to LPR Status

5. LAWFUL STATUS DOCUMENTATION  Permanent Resident Card, “Green Card” (I-551)  Reentry Permit (I-327)  Refugee Travel Document (I-571)  Employment Authorization Card (I-766)  Machine Readable Immigrant Visa (with temporary I-551 language)  Temporary I-551 Stamp (on passport or I-94/I-94A)  Arrival/Departure Record (I-94/I-94A)  Arrival/Departure Record in foreign passport (I-94)  Foreign Passport  Certificate of Eligibility for Nonimmigrant Student Status (I-20)  Certificate of Eligibility for Exchange Visitor Status (DS2019)  Notice of Action (I-797)  Document indicating membership in a federally recognized Indian tribe or American Indian born in Canada  Certification from U.S. Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR)  Office of Refugee Resettlement (ORR) eligibility letter (if under 18)  Document indicating withholding of removal  Administrative order staying removal issued by the Department of Homeland Security  Alien number (also called alien registration number or USCIS number) or 1-94 number

6. SAMPLES: STATUS DOCUMENTATION

7. IMMIGRATION BASICS  Who is an immigrant?  According to U.S. law, an immigrant is a foreign-born individual who has been admitted to reside permanently in the U.S. as a LPR.  What is an undocumented person?  An undocumented person is a person who is present in the U.S. without the permission of the U.S. government. These can be persons who is EWI or overstayed their temporary visa.  What’s the difference between a refugee and an asylee?  Refugees and asylees are people seeking protection in the U.S. on the grounds that they fear persecution in their homeland. An asylee applies for protection while in the U.S. A refugee typically applies outside of their home country for resettlement in a third country.

8. NONIMMIGRANT VS. IMMIGRANT  IMMIGRANT VISAS  Intending to reside permanently in the U.S.  Permanent Residency (“Green Card”)  U.S. Citizenship  NONIMMIGRANT VISAS  For temporary stay in the U.S.  Tourists  Students  Temporary workers  Visa stamp usually required for admission *Undocumented or EWI persons do not fall into either of these categories.

9. ELIGIBILITY FOR NON-CITIZENS  The following groups may be eligible for Medicaid and CHIP:  Qualified non-citizens who entered before August 1996;  Qualified immigrants who reach end of 5-year waiting period;  LPRs  Qualified immigrants exempt from 5-year waiting period.  Refugees  Asylees  Cuban/Haitian entrants  Trafficking victims  Veteran families  Battered non-citizens, spouses and children (VAWA)  Persons paroled into the U.S. for one year or more  Persons granted withholding of deportation or removal  Immediate relative of USC with filed I-130 petition  Pregnant women and children under 19 for CHIP and under 21 for MA  No federal funding to cover undocumented immigrants, except for payment for limited emergency services.

10. REQUIREMENTS FOR ELIGIBILITY  Generally speaking, to be eligible for any kind of MA, an individual must meet four requirements:  Be a PA state resident;  Fit into a “category” of MA;  Meet the income and asset requirements for the MA category; and  Have a qualified immigration status.  Note that for eligibility to purchase Marketplace or Qualified Health Plans or to be eligible for any federal payment assistance (e.g. tax credits), the applicant must be lawfully present.  Note that Emergency MA provides an exception to the qualified immigration status requirement.

11. BARRIERS TO CARE/SPECIAL CONSIDERATIONS  Advocates for immigrant families also have to be mindful of multiple issues that affect access to services, such as:  Mixed status families;  States should not ask for citizenship/immigration information of a non-applicant, but they can ask a non-applicant for certain eligibility information (i.e. income, tax filing status, relationship)  There is no information-sharing agreement between DPW and immigration agencies  Fear of applying for programs;  Language barriers;  Verification problems.  Applying for MA or CHIP does not automatically make someone a public charge.  Exception: individuals receiving long-term care in an institution at government expense

12. CONCLUSION  Immigration law is extremely complex, and Navigators should be aware that immigration law is always changing.  We recommending consulting with a licensed immigration attorney if you need special assistance or believe a health care consumer may be eligible for immigration benefits.  QUESTIONS?

13.  Kimberly Bennett, Esq.  bennettk@moraislaw.com bennettk@moraislaw.com  (856)313-1913  Sarah R. Caruso, Esq.  carusos@moraislaw.com carusos@moraislaw.com  (856)242-0942 Law Offices of Manuela M. Morais www.moraislaw.com Thank you.