The National Immigration Law Center sent out a press release last Friday responding to a clarification from the U.S. Immigration and Customs Enforcement that mix-status famlies (undocumented parents with legal children) will not need to fear ICE enforcement and/or harassment for signing up their children for heath care through the ACA;
On October 25 U.S. Immigration and Customs Enforcement (ICE), the immigration enforcement arm of the U.S. Dept. of Homeland Security, issued a memo titled “Clarification of Existing Practices Related to Certain Health Care Information.” It confirms that immigrant parents can enroll their U.S. citizen children and other eligible family members in health insurance programs under the ACA without triggering immigration enforcement activity.
Full text of the ICE clarification letter;
Oct. 25, 2013
Clarification of Existing Practices Related to Certain Health Care Information
Purpose
The Patient Protection and Affordable Care Act (ACA), Pub. L. No. 111-148, 124 Stat. 224, and the Social Security Act (SSA) require that individuals1 seeking coverage under a qualified health plan offered on a Health Insurance Marketplace or through an insurance affordability program (i.e., premium tax credits, cost sharing reductions, Medicaid, Children’s Health Insurance Program, or Basic Health Program) provide information regarding their immigration status and certain information about their household members to determine eligibility for such coverage. This memorandum sets forth U.S. Immigration and Customs Enforcement (ICE) civil immigration enforcement policy regarding information concerning such individuals and their household members obtained during the eligibility determination process for such coverage.
Background
The ACA, the SSA, and implementing regulations outline procedures for determining eligibility for coverage under a qualified health plan offered on a Marketplace or through an insurance affordability program. Under the laws and implementing regulations, information provided by individuals for such coverage may not be used for purposes other than ensuring the efficient operation of the Marketplace or administering the program, or making or verifying certain eligibility determinations, including verifying the immigration status of such individuals.
Agency Policy
Consistent with the ACA’s, the SSA’s, and implementing regulations’ limitations on the use of information provided by individuals for such coverage, and in line with ICE's operational focus, ICE does not use information about such individuals or members of their household that is obtained for purposes of determining eligibility for such coverage as the basis for pursuing a civil immigration enforcement action against such individuals or members of their household, whether that information is provided by a federal agency to the Department of Homeland Security for purposes of verifying immigration status information or whether the information is provided to ICE by another source.
No Private Right of Action
This document, which is intended only as internal ICE policy, is not intended to, does not, and may not be relied upon to create any rights or benefits, substantive or procedural, enforceable at law by any party in any administrative, civil, or criminal matter.
A fear amoung immigration activist regarding the ACA was that applying for coverage through the ACA would bring undocumented members of those families to ICE’s attention. Because of these barriers, eligible family members, including U.S. citizen children, would not seeking out benefits under the new law.
The ACA had already strong worded protections against immigration enforcement, however having a clarification from ICE only solidifies this as formal agency policy.
There needs to be a tremendous outreach campaign in order to alleviate these fears and ensure mix-status immigrant families understand that they have nothing to fear. Mix-status families can include multiple variations in immigration status such as a family with an undocumented mom, a “lawfully present” dad, an adolescent granted deferred action through the Deferred Action for Childhood Arrivals (DACA) program, and a child who is a U.S. citizen because he or she was born in the U.S.
Generally undocumented immigrants and DACA recipients are excluded from ACA programs but are most likely eligible for emergency Medicaid or depending on the state, more comprehensive care. In Massachusetts for example all families regardless of immigration status may be eligible for FULL Health Safety Net with family income no higher than 200% of poverty who are not eligible for other subsidized insurance care. Higher income people may be eligible for care after meeting a deductible.
It is also important for these families to understand that eligible family members may apply for coverage in the ACA marketplace, or for Medicaid or CHIP. An undocumented parent for example, may apply on behalf of eligible family members, including when the ineligible person is the head of household and the household’s primary tax return filer.
By law, individuals who are not applying for themselves (“nonapplicants”) are not required to provide information about their citizenship or immigration status and are not required to provide a Social Security number if one was never issued to them. People’s SSNs are requested so that their income can be verified with the IRS. This is important because If a member of a mixed-status household is eligible for a premium tax credit to make health insurance more affordable under the ACA and enrolls in health insurance, the household must file tax returns for the year in which the eligible person has health insurance. A tax return must be filed in order to determine the amount of the tax credit and adjust the credit from year to year. In these circumstance the NILC suggest these families use a ITIN or Individual Taxpayer Identification Number which are issued by IRS to people who are ineligible for SSNs but who need to file tax returns.
As far as the individual mandate, immigrants who are not eligible for health insurance under the ACA, including undocumented people and DACA recipients, are eligible for the exemption for “exempt noncitizens” and are not subject to the tax penalty if they do not have health insurance. U.S. citizens and lawfully present individuals in mixed-status families who are eligible for health insurance under the ACA are required to have insurance unless they are eligible for another exemption. The NILC suggest that an exempt noncitizen should be able to claim the exemption without disclosing his or her immigration status on the 2014 tax returns.
I am not affiliated with the NILC in anyway but am an immigration activist. Much of this information was gathered from their outreach materials which they have requested be disseminated as openly and as widely as possible in order for as many families who could benefit from this information find out exactly what their rights are under the ACA.