Undocumented immigrants in the United States have several options for health care, even without insurance or a Social Security number. These include emergency rooms, community health centers with sliding-scale fees, free clinics, city-run access programs, and in some states, full Medicaid-like coverage funded by the state. The options vary significantly by location, but no one is turned away from emergency care, and many routine and preventive services are available at low or no cost.
Emergency Rooms Cannot Turn You Away
Federal law requires every hospital with an emergency department to screen and stabilize anyone who comes in with an emergency medical condition, regardless of ability to pay or immigration status. This law, known as EMTALA, has been in effect since 1986 and applies to virtually every hospital in the country because it covers all facilities that participate in Medicare. If you show up at an emergency room in active labor, with chest pain, after an accident, or with any condition that could seriously threaten your health, the hospital must treat you.
EMTALA covers stabilization, not ongoing care. Once you’re medically stable, the hospital is not required to continue treating you for free. You may still receive a bill, but many hospitals have financial assistance programs (covered below) that can reduce or eliminate that cost after the fact.
Community Health Centers Charge Based on Income
Federally Qualified Health Centers (FQHCs) are one of the most reliable options for routine medical care. There are roughly 1,400 of these organizations operating at more than 15,000 sites across the country, often in underserved neighborhoods. They provide primary care, dental care, mental health services, and prescriptions, and they do not ask about immigration status as a condition of receiving care.
Every FQHC is required by federal law to use a sliding fee discount schedule based on your family size and income. If your household income is at or below the federal poverty level (about $16,000 for a single person in 2025), you qualify for a full discount and may pay nothing or only a nominal charge. The discount phases out gradually, and anyone earning above twice the poverty level pays the standard rate. To find a health center near you, search by zip code at findahealthcenter.hrsa.gov.
Free and Charitable Clinics
Hundreds of free clinics operate independently across the country, staffed largely by volunteer doctors and nurses. These clinics typically serve uninsured patients and do not require documentation of immigration status. Services vary by clinic but often include basic primary care, chronic disease management, mental health support, and cancer screenings. Some partner with pharmacies to provide free or discounted medications.
The National Association of Free and Charitable Clinics (nafcclinics.org) maintains a searchable directory. Enter your city or zip code, review the list of nearby clinics, and contact them directly to confirm services and hours. Many of these clinics operate on limited schedules, so calling ahead is important.
Hospital Financial Assistance Programs
Most nonprofit hospitals are required to offer charity care or financial assistance programs, and many for-profit hospitals offer them voluntarily. These programs can reduce or completely eliminate bills for patients who qualify based on income, regardless of immigration status. Thresholds vary by hospital, but it’s common to see full discounts for individuals earning up to 150% of the federal poverty level and partial discounts for those earning up to 300% or even 400%.
Applying typically involves providing proof of income, such as recent pay stubs or a written statement of earnings if you’re self-employed, along with information about your household size. You generally do not need a Social Security number. Most hospitals require you to apply within 180 days of receiving your first bill. If you’ve already received a large hospital bill, it is worth calling the hospital’s financial counseling department to ask about assistance, even if no one mentioned it during your visit.
State-Funded Health Coverage Programs
A growing number of states offer Medicaid-like health coverage to undocumented residents using state funds. As of late 2025, seven states and Washington, D.C. provide coverage to some income-eligible adults regardless of immigration status: California, Colorado, Illinois, Minnesota, New York, Oregon, and Washington.
California has gone the furthest, extending state-funded coverage to all low-income adults regardless of status starting in January 2024, though the state plans to pause new enrollment for most undocumented adults beginning in January 2026 and scale back dental benefits in mid-2026. Colorado uses a different approach, subsidizing marketplace insurance premiums for residents earning up to 300% of the federal poverty level through a program called OmniSalud. Illinois and Minnesota also provide coverage but have announced plans to scale back due to budget pressures.
Children have broader access. Fourteen states plus D.C. provide state-funded health coverage for income-eligible children regardless of immigration status. And for prenatal care, 22 states and D.C. cover pregnant people regardless of status through a federal option that provides coverage from the start of pregnancy through at least 60 days postpartum. States using this option include California, Georgia, Illinois, Virginia, Alabama, Maryland, Nevada, and others. The rationale is that the newborns will be U.S. citizens, so the program is structured around the health of the child.
City-Level Access Programs
Some cities have created their own health care access programs for residents who don’t qualify for insurance. NYC Care is one of the most established examples. It’s not an insurance plan, but it gives members a primary care doctor, a membership card, access to affordable medications, and care at any of the city’s 11 public hospitals and dozens of community health centers. There are no membership fees, monthly premiums, or enrollment costs. What you pay for services is based entirely on your family size and income, starting at $0.
NYC Care explicitly does not record immigration status. Interpretation services are available in over 250 languages. To be eligible, you must live in one of New York City’s five boroughs and not qualify for or be able to afford any health insurance plan available in the state. Similar programs exist in other cities, so it’s worth checking with your local public hospital system or city health department.
Privacy Protections at Health Care Facilities
Federal privacy law (HIPAA) protects your medical information regardless of your immigration status. Health care providers are legally required to safeguard your records and cannot share them with immigration enforcement agencies like ICE except under narrow legal circumstances, such as a court order or warrant. Many states add additional protections on top of federal law.
This means that visiting a clinic, hospital, or health center does not create a record that immigration authorities can access through routine channels. If law enforcement does request records, providers are generally required to follow strict internal procedures before releasing anything, which may include requiring a formal legal process like a subpoena.
Will Using Health Services Affect Immigration Status?
Fear of the “public charge” rule has kept many immigrant families from seeking care, even when they qualify. Under current federal policy, public charge determinations consider only the receipt of cash assistance programs and long-term government-funded institutional care. Using community health centers, emergency rooms, free clinics, or programs like CHIP prenatal coverage does not count against you in a public charge evaluation.
Research from PolicyLab at Children’s Hospital of Philadelphia found that even after the rule was narrowed, enrollment in health, nutrition, and housing programs remained lower among immigrant families than before. The fear caused by earlier, broader versions of the policy led people to avoid programs that were never covered by the rule in the first place, including Medicaid for children and the WIC nutrition program. Understanding what actually counts, and what doesn’t, can help you make decisions based on facts rather than fear.
What Identification You May Need
Requirements vary by facility, but community health centers and free clinics typically ask for minimal documentation. Many accept foreign-issued identification such as a passport or consular ID card (matrícula consular). Some require only proof of address, like a utility bill or a piece of mail. A Social Security number is not required at FQHCs or free clinics, though some intake forms may ask for one. You can leave that field blank or write “none” without being denied care.
For state-funded coverage programs, you’ll generally need to verify your identity, your address within the state, and your household income. Accepted documents vary by state but often include foreign passports, consular IDs, or other government-issued identification from any country. If you’re unsure what to bring, call the clinic or enrollment office ahead of time.