Can an illegal immigrant buy health insurance in Covered CA? Outside of Covered CA? Can they get subsidies?

Bill pending for CA Covered CA to request permission from the Federal Government.  This still won’t give APTC – subsidies to illegal immigrants. CA HealthLine 6.10.2016    SB 10  Covered CA         SB 4  Medi-Cal See below – illegal immigrants can buy coverage now through an agent or direct from the Insurance Company.

Covered California & The Health Law

California Inches Closer To Offering Coverage Under Health Law To Those In U.S. Illegally

Gov. Jerry Brown signed legislation that would require the state to seek a waiver from the federal government to allow immigrants in the country illegally to buy insurance from Covered California exchanges. They would not be eligible for subsidies.

The Associated Press: California Moves To Open Health Care Exchange To Undocumented People California Gov. Jerry Brown has approved a path to open the state’s health care exchange to people who cannot prove they are legally in the country. Brown signed a law Friday that would allow undocumeted immigrants to buy insurance through the state marketplace but not receive government-subsidized health care. (6/10)

Reuters: California Governor Signs Bill Letting Undocumented Immigrants Buy Insurance California Governor Jerry Brown signed a bill into law allowing unauthorized immigrants to buy health insurance on a state exchange created under the U.S. Affordable Care Act, making the state the first in the country to offer that kind of coverage. The law lets the state request a waiver from the federal government that will be needed to allow unauthorized immigrants to purchase unsubsidized insurance through Covered California, the state’s healthcare exchange. (O’Brien, 6/11)

Los Angeles Times: Gov. Brown Signs Bill That Could Help Immigrants Get Access To Health Insurance The new law is the latest immigrant-friendly policy recently passed in California. Over the last few years, immigrants here illegally have gained the ability to apply for professional licenses, such as for practicing law or medicine, and also for drivers licenses. Opponents of these policies say they encourage illegal immigration and take away resources from those here legally. But immigrant advocates have praised California’s efforts, especially those around expanding healthcare. (Karlamangla, 6/10)

The Sacramento Bee: Gov. Jerry Brown Agrees To Seek Health Insurance For Undocumented Immigrants “Today we ask the federal government to remove barriers to health insurance access that discriminates against some of our residents on the basis of their documentation status,” Sen. Ricardo Lara, D-Bell Gardens, said in a statement. “The current policy disallowing immigrants from purchasing care with their own money is both discriminatory and outdated.” (White, 6/10)

California Healthline: Gov. Brown Signs Bill Seeking OK For Exchange To Sell To Immigrants Without Documents Under the terms of California’s request to the federal government, immigrants without legal standing would not qualify for government assistance to help pay for the coverage — unlike the vast majority of Covered California enrollees. Many experts and advocates concede that this makes the measure a largely symbolic gesture, since few would be able to afford policies on their own. They are allowed to buy coverage in the private market, but many decline to do so for financial reasons, insurance industry experts say. (Ibarra, 6/10)

Kevin Knausssays:
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.
  • Here’s a specimen platinum policy off exchange – see page 25 – which does state that one must be a lawful resident. However, the Blue Cross Application doesn’t ask the question. Maybe the rules have become less stringent since 2014? I will grant that the Confidential Agent Manual for 2016 page 16 uses the term “resident” not lawfully present. The 2016 Blue Cross Direct Page 29 EOC uses the term Reside and not lawfully present. 45 CFR 147.104 (a) Guaranteed availability of coverage in the individual and group market. Subject to paragraphs (b) through (d) of this section, [Open and Special Enrollment] a health insurance issuer that offers health insurance coverage in the individual, small group, or large group market in a State must offer to any individual or employer in the State all products that are approved for sale in the applicable market, and must accept any individual or employer that applies for any of those products. (e) Marketing. A health insurance issuer and its officials, employees, agents and representatives must comply with any applicable state laws and regulations regarding marketing by health insurance issuers and cannot employ marketing practices or benefit designs that will have the effect of discouraging the enrollment of individuals with significant health needs in health insurance coverage or discriminate based on an individual’s race, color, national origin, present or predicted disability, age, sex, gender identity, sexual orientation, expected length of life, degree of medical dependency, quality of life, or other health conditions. One not lawfully present has an exemption from the mandate.
    • I checked with Blue Cross and here is their reply. Can an illegal resident purchase an off Covered CA policy? No. We follow the same rules as CoveredCa, since they are one of the regulators for Individual. I am surprise their producer manual does not state ‘lawfully present’, my understanding is that you must be here legally to qualify for a subsidy. Either its Covered Cal plan(On Exchange) or direct(Off Exchange), not both.
      • Updated Reply from BC As long as the applicant can provide proof of residency not so much legal residency they may apply. Once the information is submitted the applicant will be contacted to get a hold of a SSN or a reason for a lack of SSN. The documentation that states this information as required proof of residency is in your agent contract.
      • Max H says:
        They are full of shit. [Technical Insurance Term – Max is referring to the 1st reply from Blue Cross] Of course, to get APTCs one must be a legal resident — but I know of no legal entanglement an insurance company would find itself in if it sold an off-exchange iFP to an illegal immigrant. If CA had its way, every illegal immigrant would get Medi-Cal. Also — look at the footnote on the CoveredCA group application that specifically states no proof of residency (or maybe it says lawful presence) is required. They are trusting the feds to enforce immigration law when it comes to hiring illegal immigrants, which we know is not currently happening. And won’t be in the future if Bernie Sanders is elected POTUS — another 4-8 years of “democratic socialism” will completely derail America as we know it. Forget health insurance companies — we’ll have “free” health insurance for everyone in America, paid for by the handful of people who choose to continue working instead of sitting on their asses and collecting the government dole. Exactly what caused the collapse of the Soviet Union — a 50-year failed experiment with socialism. And look at the trouble China is having trying to remain communist in the face of expanding capitalism — the only weapon they have is monetary policy which has come back to bite them on the butt. MAX Webmaster’s Note – Max is on the CA Dept. of Insurance Curriculum Board – amongst other accomplishments Learn more

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