Yes, immigrants can have health insurance in the United States, and most lawfully present immigrants qualify for the same coverage options as U.S. citizens. The specifics depend on immigration status, how long you’ve lived in the country, your income, and which state you live in. Even undocumented immigrants have some options, though they are far more limited.
Marketplace Coverage for Lawfully Present Immigrants
The federal health insurance Marketplace (HealthCare.gov) is open to a wide range of immigration statuses. Green card holders, refugees, asylees, people with Temporary Protected Status, those paroled into the U.S., and holders of work visas, student visas, U-visas, and T-visas can all enroll in Marketplace plans. The list also includes people with employment authorization documents, those granted withholding of deportation, special immigrant visa holders from Iraq and Afghanistan, citizens of the Marshall Islands, Micronesia, and Palau living in the U.S., and several other categories.
If you’re applying for certain statuses (like adjustment to green card status or special immigrant juvenile classification), you may also qualify while your application is pending.
Lawfully present immigrants who meet income requirements can receive the same financial help as citizens: premium tax credits that lower monthly costs and cost-sharing reductions that lower out-of-pocket expenses at the doctor. There’s actually one area where eligible immigrants get better access to subsidies than some citizens. Lawfully present immigrants who earn below the federal poverty level can qualify for Marketplace tax credits, even at income levels where a U.S. citizen would instead be directed to Medicaid. This matters especially during the five-year Medicaid waiting period (more on that below), because immigrants in that gap aren’t left without affordable options.
The Five-Year Medicaid Waiting Period
Most lawfully present immigrants must wait five years after receiving their qualifying immigration status before they can enroll in Medicaid or the Children’s Health Insurance Program (CHIP). This is a federal rule that applies regardless of income.
Several groups are exempt from this waiting period. Refugees, asylees, and certain trafficking victims can access Medicaid immediately. Pregnant women and children in many states also have pathways that bypass the five-year rule, depending on state policy. Refugees who don’t qualify for Medicaid may be eligible for Refugee Medical Assistance, a separate federal program that covers medical costs during the initial resettlement period.
If you’re in the five-year waiting period and your income would otherwise qualify you for Medicaid, you can purchase a Marketplace plan with subsidies instead. For subsidy calculations, if your income falls below the poverty level, it’s treated as though it equals the poverty level, which keeps you eligible for meaningful financial assistance.
Employer-Sponsored and Private Insurance
Nothing in federal law prevents immigrants from enrolling in employer-sponsored health insurance. If your employer offers a health plan and you’re eligible for it based on your job status, your immigration status doesn’t disqualify you. This is the most straightforward path to coverage for many immigrants, particularly those on work visas. You can also purchase private insurance directly from an insurer outside the Marketplace, though you won’t receive federal subsidies that way.
DACA Recipients Face Ongoing Uncertainty
The situation for people with Deferred Action for Childhood Arrivals (DACA) status has been turbulent. In 2024, the federal government finalized a rule that would have allowed DACA recipients to enroll in Marketplace plans with financial assistance starting November 1, 2024. Under that rule, DACA recipients would have been treated the same as other individuals with deferred action status for the purposes of Marketplace and Basic Health Program eligibility.
However, a court order has since blocked that change. As of August 2025, DACA recipients are not eligible for Marketplace coverage. They also remain excluded from Medicaid and CHIP under federal rules. This leaves DACA recipients relying on employer-sponsored insurance, private insurance purchased at full price, or state-funded programs in the handful of states that offer them.
State Programs for Undocumented Residents
Undocumented immigrants are not eligible for Marketplace plans, Medicaid, or CHIP under federal law. But a growing number of states have stepped in with their own fully state-funded programs.
As of early 2024, 12 states and Washington, D.C., provide state-funded health coverage to income-eligible children regardless of immigration status: California, Connecticut, Illinois, Maine, Massachusetts, New Jersey, New York, Oregon, Rhode Island, Utah, Vermont, and Washington. Six of those states (California, Colorado, Illinois, New York, Oregon, and Washington) plus D.C. have also expanded coverage to some income-eligible adults regardless of status. Eligibility rules, age limits, and income thresholds vary by state.
These programs are funded entirely with state dollars, which is what allows them to cover people who federal law excludes. If you live in one of these states, it’s worth checking your state’s health coverage website for current eligibility details.
Emergency Medicaid and Safety Net Care
Regardless of immigration status, anyone in the U.S. can receive Emergency Medicaid for a qualifying emergency medical condition. To qualify, the condition must be one that, without immediate treatment, could place your health in serious jeopardy, cause serious impairment to bodily functions, or lead to serious dysfunction of a bodily organ. Ongoing chronic conditions don’t qualify on their own.
Childbirth is considered a qualifying emergency. Emergency Medicaid covers the month of delivery and the following month, and the newborn is automatically eligible for coverage. However, postpartum coverage for the mother beyond that window is not included under emergency provisions.
Community health centers, funded by the federal government, also provide primary care on a sliding fee scale based on income. They serve patients regardless of immigration status or ability to pay, and they exist in every state.
Using Health Benefits Won’t Hurt Your Immigration Case
One of the biggest concerns immigrants have is whether using public benefits will count against them in a “public charge” determination, which could affect a green card application or other immigration proceedings. Under current rules from U.S. Citizenship and Immigration Services, most health-related benefits are explicitly excluded from public charge evaluations.
USCIS does not consider Medicaid (except for long-term institutional care), CHIP, health insurance purchased through the Affordable Care Act, premium tax credits, emergency medical services, immunizations, testing and treatment of communicable diseases, or home and community-based services. These are all listed as benefits that will not be held against you.
Refugees are fully exempt from the public charge ground of inadmissibility. If a refugee later applies for a green card through a family petition, any benefits received during their refugee status period are not considered. The only health-related benefit that could factor into a public charge analysis is Medicaid used specifically for long-term institutional care, such as a nursing home stay paid for by Medicaid.