August 2019 ALERT - On Monday August 12, 2019, the Department of Homeland Security finalized a rule that dramatically expands the “public charge” immigration policy. The changes will apply only to applications that are postmarked or submitted electronically on or after October 15, 2019. They change the definition for deciding whether an immigrant who receives Medicaid or other government benefits is considered a "public charge" -- which can result in denial of Lawful Permanent Resident status (green card), denial of an extension of a non-immigrant visa, or deny admission to the U.S. Read more about this here. While PRUCOL immigrants in NYS will still be eligible for Medicaid, the rule, if adopted, will deter many from accessing health care out of fear of adverse immigration consequences. See New England Journal of Medicine article, A New Threat to Immigrants’ Health — The Public-Charge Rule, Sept. 8, 2018. See more about this here.
Current Medicaid Rules For People who are Not Lawful Permanent Residents (Do Not Have "Green Cards")
Federal law, since 1996, limits Medicaid eligibility to US citizens and “Qualified Aliens,” which include:
See Empire Justice Center's Immigrant Eligibility Crosswalk which gives detailed eligibility information for immigrants for various health programs (2015)(But see this later information about 2016 changes for non-immigrants)
New York State, fortunately, is more liberal. Many people mistakenly think an immigrant must have a "green card" (formally called a "lawful permanent resident" ) or be a refugee, in order to be eligible for Medicaid. This is not true, at least not in New York State. Thanks to the New York State Constitution and a 2001 decision of New York's highest court in a case called Aliessa v. Novello, many (but not all) immigrants who do not have "green cards" are eligible for Medicaid in New York State. Their Medicaid is paid for by the State exclusively, without any federal contribution -- but that does not affect the immigrant. The Medicaid they have is the same.
New York grants Medicaid eligibility to two broad categories of immigrants who are not lawful permanent residents or humanitarian immigrants, described below.
Immigrants who do not have a green card (permanent resident alien formally known as the "qualified alien category") but who are permanently residing under color of law (PRUCOL) are eligible for full Medicaid in New York State. (see also
New York’s Exchange Portal: A Gateway to Coverage for Immigrants, published 9/14/15, by Empire Justice Center reviews current rules on eligibility and describes how immigrants can access health care through NYSof Health portal, including for emergency care for those who are undocumented and not PRUCOL.
Current NYS DOH policy defining the PRUCOL category can be found at:
Immigrants should be classified as PRUCOL by the social services district if :
These factors are described more below.
The client is PRUCOL as long as the application is pending, and in some circumstances PRUCOL status may continue after the application is denied. For example, a notice denying a deferred action application states, “Denial of a request for deferred action does not necessarily mean that USCIS intends affirmatively to pursue your client’s removal.” Some Fair Hearing decisions state that while the application may have been denied, the facts and circumstances of the case indicate that the federal government does not intend to affirmatively enforce the person's removal. See, e.g. Fair Hearing No. 6805696N (NYC 10/17/14), Fair Hearing No. 6901593N (NYC 3/24/15), and Fair Hearing No.6417893Q (Dutchess Co. 1/17/2014).
2. WHAT PROOF IS NEEDED THAT AN IMMIGRATION AGENCY IS NOT ENFORCING THEIR DEPARTURE?
Either A or B:
B. The Immigration agency has not acted on an application or a letter, of the types described in #1 above.
Temporary non-immigrants are individuals who are allowed to enter the United States temporarily for a specific purpose and for a specific period of time. They are commonly referred to as short-term visa holders. There are more than two dozen temporary non-immigrant categories. A few of the more common temporary non-immigrant categories are tourists, students and visitors for business. See list at Temporary Non-Immigrant Document Types and Visa Codes, which is Attachment II of GIS 16 MA/002 - Changes in Medicaid Coverage for Temporary Non-Immigrants. This list also includes examples of the types of documentation that temporary non-immigrants will typically possess. Under the GIS, the individual must not have violated the terms of the status under which he or she was admitted to the U.S. (i.e., the individual must not have overstayed his or her visa.
Before this GIS was issued in 2016, temporary non-immigrants were only eligible for Emergency Medicaid, unless they were pregnant women or children. NYS is exercising an option afforded to states to cover all temporary non-immigrants if they are "lawfully present" in the U.S., are state residents, and meet all other Medicaid eligibility requirements. This option is granted under the Children's Health Insurance Program Reauthorization Act of 2009, as interpreted in guidance issued by CMS in 2010. See GIS.
To determine if they are state residents, the "Residency Review Worksheet" (Spanish version) must be given to all temporary non-immigrants applying for Medicaid. The applicant must answer YES to one of the questions to qualify as a resident. See the GIS for more information. If they do not qualify as a resident, they are only eligible for Emergency Medicaid -- again, unless they are pregnant women or children.
The GIS and all of its attachments can be found here
WARNING: IMMIGRATION RULES ARE VERY COMPLICATED.