Government Immigration Website
Federal Immigration Website
CA Residency Guidelines FTB # 1031
CA Residency Guidelines FTB # 1031
lawfully.present.nilc
NILC.org 7 page treatise on Lawfully Present
Tax Guide for Aliens - Publication 519
Tax Guide for Aliens – Publication 519
 

Report aspe immigration
ASPE 16 Page Brief – Immigration & Affordable Care Act

What does the requirement of being
“Lawfully Present
45 CFR 152.2  mean?

Lawful presence in the USA is a requirement to be subject to the Health Insurance Mandate Penalty  and to get tax credits in Covered CA. 

Learn More ===>

Immigration Status Law Center explanation

Covered CA Application page 27

How to find receipt # on green card

If you want coverage without subsidies, you  can purchase direct from an Insurance Company, with the only requirement being that you  reside in CA, even if you don’t have legal status.

There is no charge for our help, when you appoint us as your agent by using the enrollment links in this website or using “find local help” in the upper right hand portion of the Covered CA Online Application.

Latest Information for 2016 Enrollment & Renewals

Resources ToolKit  Rev 1.2015 includes Immigration Status, FAQ’s, Lawfully Present FAQ’s, Acceptable Documentation Rev 11.2015

Renewal Tool Kit for 2016

Here are samples of acceptable documents that Covered CA will accept as proof ♦ November 2015 ListinFAQ’s2015 Verification

If you do NOT qualify, you can try an International Policy Under the Health Reform Law, you must be lawfully present to get coverage outside of Covered CA too. page 25 Specimen Evidence of Coverage or excerpt below from agents manual.

Covered CA Application 7 Page Worksheet to complete ONLINE Application

The National Immigration Law Center has written an excellent 7 page pdf on what are the eligible categories, as defined under 45 CFR 152.2 “Lawfully Present.” Covered CA Summary – “Legally Present”?

Medi-Cal Health Insurance will not count against you for immigration purposes as a
public charge
.

Oops!!! - This changed!  Now it might, does.

Learn more:  LA Times 8.12.2019  * Federal Register *  CA suing to block new Federal Rule Sacramento Bee 8.20.2019 * KHN.org  * CA HealthLine 8.26.2019 * Fresno Bee  *  LA Times  *    LA Times 8.12.2019  * Federal Register *

Fact Sheet that Covered CA sent to Agents 

President Trump Proclamation of mandatory health insurance starting 11.4.2019 CHCF *  - What Coverages Qualify? 
Judges Ruling Blocks this Proclamation KTLA * Politico * 

 

Best Synopsis and Explanation I've Found CHFC website 

Court Blocks public charge protecting immigrant families.org  

 

A. Non-cash benefits (other than institutionalization for long-term care) are generally not taken into account for purposes of a public charge determination.

Special-purpose cash assistance is also generally not taken into account for purposes of public charge determination.

Non-cash or special-purpose cash benefits are generally supplemental in nature and do not make a person primarily dependent on the government for subsistence. Therefore, past, current, or future receipt of these benefits do not impact a public charge determination. Non-cash or special purpose cash benefits that are not considered for public charge purposes include:

Medicaid [Medi-Cal] and other health insurance and health services (including public assistance for immunizations and for testing and treatment of symptoms of communicable diseases; use of health clinics, short-term rehabilitation services, and emergency medical services) other than support for long-term institutional care

Children's Health Insurance Program (CHIP)

Nutrition programs, including Food Stamps, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the National School Lunch and School Breakfast Program, and other supplementary and emergency food assistance programs

Housing benefits

Child care services

Energy assistance, such as the Low Income Home Energy Assistance Program (LIHEAP)

Emergency disaster relief

Foster care and adoption assistance

Educational assistance (such as attending public school), including benefits under the Head Start Act and aid for elementary, secondary, or higher education

Job training programs

In-kind, community-based programs, services, or assistance (such as soup kitchens, crisis counseling and intervention, and short-term shelter)

State and local programs that are similar to the federal programs listed above are also generally not considered for public charge purposes. Please be aware that states may adopt different names for the same or similar publicly funded programs. It is the underlying nature of the program, not the name adopted in a particular state, which determines whether or not it should be considered for public charge purposes. In California, for example, Medicaid is called "Medi-Cal" and CHIP is called "Healthy Families." These benefits are not considered for public charge purposes.

In addition, and consistent with existing practice, cash payments that have been earned, such as Title II Social Security benefits, government pensions, and veterans' benefits, among other forms of earned benefits, do not support a public charge determination. Unemployment compensation is also not considered for public charge purposes.  USCIS.Gov  *

Public Charge?

VIDEO

Comparison of Eligibility Rules - Covered CA - Medi-Cal

Medi-Cal Qualification

The complete list of “qualified” immigrants includes those listed at

8 U.S.C. § 1641 Definitions

and Trafficking Victims as a result of) the Victims of Trafficking and Violence Protection Act of 2000, Pub. L. No. 106–386, § 107 (Oct. 28, 2000) and the

Trafficking Victims Protection Reauthorization Act of 2003, Pub. L. No. 108–193, § 4(a)(2) (Dec. 19, 2003).

See also “Table: A Quick Guide to Immigrant Eligibility for Affordable Care Act (ACA) and Key Federal Means-tested Programs,” National Immigration Law Center, September 2015, available at: https://www.nilc.org/document.html?id=844.

Technical and Research Resources

Covered CA Q & A on Immigration Status

Immigrants 

Health Care.gov on immigrants

Immigration Document Types

Coverage and Issues for Immigrant Families – aspe.hhs.gov (pdf)

Attorney Guide to determine Citizen Status in Criminal Cases

Publication 1031 CA Residency Guidelines

 

Covered CA Webinar on verification of residency Proposed Regulations 5.2013 Covered CA Q & A Residency Medi-Cal Handbook

immigration policy.org

What if you are not lawfully present and you try to apply for coverage? Will it be reported to INS?

 

FAQ’s Kaiser Foundation kff.org/immigrants

New Obama Immigration may allow those to get Medi-Cal californiahealthline.org/2014/11/21

4 page – Immigration Status and Covered Ca hbex.coveredca.com

 

§ 152.2 Definitions.

For purposes of this part the following definitions apply:

Creditable coverage means coverage of an individual as defined in section 2701(c)(1) of the Public Health Service Act as of March 23, 2010 and 45 CFR 146.113(a)(1).

Enrollee means an individual receiving coverage from a PCIP established under this section.

Lawfully present means

(1) A qualified alien as defined in section 431 of the Personal Responsibility and Work Opportunity Act (PRWORA) ( 8 U.S.C. 1641);

(2) An alien in nonimmigrant status who has not violated the terms of the status under which he or she was admitted or to which he or she has changed after admission;

(3) An alien who has been paroled into the United States pursuant to section 212(d)(5) of the Immigration and Nationality Act (INA) ( 8 U.S.C. 1182(d)(5)) for less than 1 year, except for an alien paroled for prosecution, for deferred inspection or pending removal proceedings;

(4) An alien who belongs to one of the following classes:

(i) Aliens currently in temporary resident status pursuant to section 210 or 245A of the INA ( 8 U.S.C. 1160 or 1255a, respectively);

(ii) Aliens currently under Temporary Protected Status (TPS) pursuant to section 244 of the INA ( 8 U.S.C. 1254a), and pending applicants for TPS who have been granted employment authorization;

(iii) Aliens who have been granted employment authorization under 8 CFR 274a.12(c)(9), (10), (16), (18), (20), (22), or (24);

(iv) Family Unity beneficiaries pursuant to section 301 of Public Law 101-649 as amended;

(v) Aliens currently under Deferred Enforced Departure (DED) pursuant to a decision made by the President;

(vi) Aliens currently in deferred action status;

(vii) Aliens whose visa petitions have been approved and who have a pending application for adjustment of status;

(5) A pending applicant for asylum under section 208(a) of the INA ( 8 U.S.C. 1158) or for withholding of removal under section 241(b)(3) of the INA ( 8 U.S.C. 1231) or under the Convention Against Torture who has been granted employment authorization, and such an applicant under the age of 14 who has had an application pending for at least 180 days;

(6) An alien who has been granted withholding of removal under the Convention Against Torture; or

(7) A child who has a pending application for Special Immigrant Juvenile status as described in section 101(a)(27)(J) of the INA ( 8 U.S.C. 1101(a)(27)(J)).

(8)Exception. An individual with deferred action under the Department of Homeland Security’s deferred action for childhood arrivals process, as described in the Secretary of Homeland Security’s June 15, 2012, memorandum, shall not be considered to be lawfully present with respect to any of the above categories in paragraphs (1) through (7) of this definition.

Out-of-pocket costs means the sum of the annual deductible and the other annual out-of-pocket expenses, other than for premiums, required to be paid under the program.

Pre-Existing condition exclusion has the meaning given such term in 45 CFR 144.103.

Pre-Existing Condition Insurance Plan (PCIP) means the temporary high risk health insurance pool plan (sometimes referred to as a “qualified high risk pool”) that provides coverage in a State, or combination of States, in accordance with the requirements of section 1101 of the Affordable Care Act and this part. The term “PCIP program” is generally used to describe the national program the Secretary is charged with carrying out, under which States or non-profit entities operate individual PCIPs.

Resident means an individual who has been legally domiciled in a State.

Service Area refers to the geographic area encompassing an entire State or States in which PCIP furnishes benefits.

State refers each of the 50 States and the District of Columbia.

[ 75 FR 45029, July 30, 2010, as amended at 77 FR 52616, Aug. 30, 2012]
 

8 US Code §1641 Definitions

 
(a) In general

Except as otherwise provided in this chapter, the terms used in this chapter have the same meaning given such terms in section 101(a) of the Immigration and Nationality Act [8 U.S.C. 1101(a)].
(b) Qualified alienFor purposes of this chapter, the term “qualified alien” means an alien who, at the time the alien applies for, receives, or attempts to receive a Federal public benefit, is—

(1)

an alien who is lawfully admitted for permanent residence under the Immigration and Nationality Act [8 U.S.C. 1101 et seq.],
(2)

an alien who is granted asylum under section 208 of such Act [8 U.S.C. 1158],
(3)

a refugee who is admitted to the United States under section 207 of such Act [8 U.S.C. 1157],
(4)an alien who is paroled into the United States under section 212(d)(5) of such Act [8 U.S.C. 1182(d)(5)] for a period of at least 1 year,
(5)an alien whose deportation is being withheld under section 243(h) of such Act [8 U.S.C. 1253] (as in effect immediately before the effective date of section 307 of division C of Public Law 104–208) or section 241(b)(3) of such Act [8 U.S.C. 1231(b)(3)] (as amended by section 305(a) of division C of Public Law 104–208),
(6)an alien who is granted conditional entry pursuant to section 203(a)(7) of such Act [8 U.S.C. 1153(a)(7)] as in effect prior to April 1, 1980; [1] or
(7)an alien who is a Cuban and Haitian entrant (as defined in section 501(e) of the Refugee Education Assistance Act of 1980).
(c) Treatment of certain battered aliens as qualified aliensFor purposes of this chapter, the term “qualified alien” includes—

(1) an alien who—

(A)has been battered or subjected to extreme cruelty in the United States by a spouse or a parent, or by a member of the spouse or parent’s family residing in the same household as the alien and the spouse or parent consented to, or acquiesced in, such battery or cruelty, but only if (in the opinion of the agency providing such benefits) there is a substantial connection between such battery or cruelty and the need for the benefits to be provided; and
(B) has been approved or has a petition pending which sets forth a prima facie case for—

(i)status as a spouse or a child of a United States citizen pursuant to clause (ii), (iii), or (iv) of section 204(a)(1)(A) of the Immigration and Nationality Act [8 U.S.C. 1154(a)(1)(A)(ii), (iii), (iv)],
(ii)classification pursuant to clause (ii) or (iii) of section 204(a)(1)(B) of the Act [8 U.S.C. 1154(a)(1)(B)(ii), (iii)],
(iii)suspension of deportation under section 244(a)(3) of the Immigration and Nationality Act [8 U.S.C. 1254(a)(3)] (as in effect before the title III–A effective date in section 309 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996).[2]
(iv)status as a spouse or child of a United States citizen pursuant to clause (i) of section 204(a)(1)(A) of such Act [8 U.S.C. 1154(a)(1)(A)(i)], or classification pursuant to clause (i) of section 204(a)(1)(B) of such Act [8 U.S.C. 1154(a)(1)(B)(i)]; [3]
(v)cancellation of removal pursuant to section 240A(b)(2) of such Act [8 U.S.C. 1229b(b)(2)];
(2) an alien—

(A)whose child has been battered or subjected to extreme cruelty in the United States by a spouse or a parent of the alien (without the active participation of the alien in the battery or cruelty), or by a member of the spouse or parent’s family residing in the same household as the alien and the spouse or parent consented or acquiesced to such battery or cruelty, and the alien did not actively participate in such battery or cruelty, but only if (in the opinion of the agency providing such benefits) there is a substantial connection between such battery or cruelty and the need for the benefits to be provided; and
(B)who meets the requirement of subparagraph (B) of paragraph (1);
(3) an alien child who—

(A)resides in the same household as a parent who has been battered or subjected to extreme cruelty in the United States by that parent’s spouse or by a member of the spouse’s family residing in the same household as the parent and the spouse consented or acquiesced to such battery or cruelty, but only if (in the opinion of the agency providing such benefits) there is a substantial connection between such battery or cruelty and the need for the benefits to be provided; and

(B)who meets the requirement of subparagraph (B) of paragraph (1); or

(4)an alien who has been granted nonimmigrant status under section 101(a)(15)(T) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(T)) or who has a pending application that sets forth a prima facie case for eligibility for such nonimmigrant status.
This subsection shall not apply to an alien during any period in which the individual responsible for such battery or cruelty resides in the same household or family eligibility unit as the individual subjected to such battery or cruelty.
After consultation with the Secretaries of Health and Human Services, Agriculture, and Housing and Urban Development, the Commissioner of Social Security, and with the heads of such Federal agencies administering benefits as the Attorney General considers appropriate, the Attorney General shall issue guidance (in the Attorney General’s sole and unreviewable discretion) for purposes of this subsection and section 1631(f) of this title, concerning the meaning of the terms “battery” and “extreme cruelty”, and the standards and methods to be used for determining whether a substantial connection exists between battery or cruelty suffered and an individual’s need for benefits under a specific Federal, State, or local program.
(Pub. L. 104–193, title IV, § 431, Aug. 22, 1996, 110 Stat. 2274; Pub. L. 104–208, div. C, title III, § 308(g)(8)(E), title V, § 501, Sept. 30, 1996, 110 Stat. 3009–624, 3009–670; Pub. L. 105–33, title V, §§ 5302(c)(3), 5562, 5571(a)–(c), 5581(b)(6), (7), Aug. 5, 1997, 111 Stat. 599, 638, 640, 643; Pub. L. 106–386, div. B, title V, § 1508, Oct. 28, 2000, 114 Stat. 1530; Pub. L. 110–457, title II, § 211(a), Dec. 23, 2008, 122 Stat. 5063.)

[1]  So in original. The semicolon probably should be a comma.

[2]  So in original. The period probably should be a comma.

[3]  So in original. The semicolon probably should be “, or”.

Steve Shorr - Covered CA Certified Agent

Steve Shorr - Covered CA Certified Agent -
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Attorney Guide Determine Citzenship in Criminal Cases
Attorney Guide Determine Citzenship in Criminal Case
immigration.status.covered.ca
Eligible Immigration Status from Covered CA ONLINE Application

 

17 comments on “Lawfully Present – Immigration Status

  1. me and my wife are only visitors with tourist visa,

    she is currently pregnant in last months,

    my income in another country is about 70 thousand US dollar per year.

    she is not working, family size 4.

    so can we apply for any option for maternity services,

    because it is very expensive in California,

  2. Off exchange plans may not require lawfully present documentation on the part of the prospective health plan member. Any plan sold through the exchange and eligible for APTC can only be sold to lawfully present individuals that can provide proof. Eligibilty conditions for enrollment in a specific health plan can usually be found in the carrier’s Evidence of Coverage.

  3. I have my lady I’ve been with for 25 years that has a social security number …but her immigration status wasn’t fixed…….I am getting the adjustment of lpr [lawful presence?] filed this week….we got married on the dec 31….she’s been here for 35 years. ..

    I need to get her real coverage….I was stuck overseas and just came back yesterday!!!

    What can I do? Help…. she has a cancer…..

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