Treatment of Noncitizens in H.R. 3200
Noncitizens and Provisions in H.R. 3200
Credits
In 2013, under §241 of H.R. 3200, certain individuals would be
eligible for premium credits (i.e.,
subsidies based on income) toward their required purchase of health
insurance. Even when
individuals have health insurance, they may be unable to afford the
cost sharing (deductible and
copayments) required to obtain health care. Under H.R. 3200, those
eligible for premium credits
would also be eligible for cost-sharing credits (i.e., subsidies).
To be eligible for credits,
individuals must have family income of less than 400% of the federal
poverty level (FPL), among
other requirements.28
To be eligible for the credits under §242 of H.R. 3200, individuals
must be lawfully present in a
state in the United States, but generally not in the United States
temporarily (i.e.,
nonimmigrants).29 Nonimmigrants—that is, foreign nationals who are
admitted to the United
States for a specified period of time and a specific purpose—are
“lawfully present,” but most,
with exceptions noted below, would be ineligible for the credits
under H.R. 3200. The exceptions
for nonimmigrants who could obtain credits under H.R. 3200 would be
trafficking victims, crime
victims, fiancées of U.S. citizens, and those who have had
applications for legal permanent
residence (LPR) status pending for three years; these individuals
are likely to become LPRs (i.e.,
immigrants) and remain in the United States permanently.
Furthermore, §246 would bar
unauthorized aliens from receiving any premium or cost-sharing
credit.30
Notably, many categories of nonimmigrants in the United States who
have work authorization
(i.e., temporary workers) would meet the definition of a resident
alien, and as a result would be
required under H.R. 3200 to have health insurance. Nonetheless, many
of these aliens would be
ineligible for the credits under the bill. For example, professional
specialty workers (H-1B) are
admitted to the United States for up to three years, and can stay
for a maximum of six years.
Thus, in general, these aliens would be considered resident aliens
under the I.R.C. and would be
required under H.R. 3200 to have health insurance, but would be
ineligible for the credits under
the bill because they are nonimmigrants.31
In addition, the credits are based on an individual’s eligibility,
but many tax returns are filed
jointly or with dependents. There could be instances where some
family members would meet the
definition of an eligible individual for purposes of the credit,
while other family members would
not. For example, in a family consisting of a U.S. citizen married
to an unauthorized alien and a
U.S. citizen child, the U.S. citizen spouse and child could meet the
criteria for being a crediteligible
individual, while the unauthorized alien spouse would not meet the
criteria. H.R. 3200
does not expressly address how such a situation would be treated.
Therefore, it appears that the
Health Choices Commissioner would be responsible for determining how
the credits would be
administered in the case of mixed-status families. 32
Some have expressed concerns that since H.R. 3200 does not contain a
mechanism to verify
immigration status, the prohibitions on certain noncitizens (e.g,
nonimmigrants and unauthorized
aliens) receiving the credits may not be enforced. However, others
note that under §142(a)(3) of
the bill, it is the responsibility of the Health Choices
Commissioner (Commissioner) to administer
the “individual affordability credits under subtitle C of title II,
including determination of
eligibility for such credits.” Thus, it appears, absent of a
provision in the bill specifying the
verification procedure, that the Commissioner would be responsible
for determining a mechanism
to verify the eligibility of noncitizens for the credits.33
Endnotes
26 For more on the Exchange, see CRS Report R40724,
Private Health Insurance Provisions of H.R. 3200, by Hinda
Chaikind et al.
27 H.R. 3200 would not change any of the alien
eligibility restrictions on the receipt of Medicaid. Thus, there
could be
aliens who would meet the categorical and income eligibility
requirements for Medicaid but are ineligible due to their
alien status (e.g., legal permanent residents within five years
after entry to the United States), who under H.R. 3200
would be required to have health insurance.
28 The federal poverty level used for public program
eligibility varies by family size and by whether the individual
resides in the 48 contiguous states and the District of Columbia
versus Alaska and Hawaii. For a two-person family in
the 48 contiguous states and the District of Columbia, the federal
poverty level (i.e., 100% of poverty) was $14,570.
See 74 Federal Register 4200, January 23, 2009,
http://aspe.hhs.gov/poverty/09fedreg.pdf.
29 The actual provision reads: “an individual who is
lawfully present in a State in the United States (other than as a
nonimmigrant described in a subparagraph (excluding subparagraphs
(K), (T), (U), and (V)) of section 101(a)(15) of
the Immigration and Nationality Act).” (H.R. 3200, §242(a)(1))
30 In addition, in the subtitle of H.R. 3200
pertaining to premium credits, §246 states, “Nothing in this
subtitle shall
allow Federal payments for affordability credits on behalf of
individuals who are not lawfully present in the United
States.”
31 For more information on the categories of
nonimmigrants who are entitled to work in the United States,
including
their approved length of stay in the country, see CRS Report
RL33977, Immigration of Foreign Workers: Labor
Market Tests and Protections, by Ruth Ellen Wasem, and CRS Report
RL31381, U.S. Immigration Policy on
Temporary Admissions, by Chad C. Haddal and Ruth Ellen Wasem.
32 The Commissioner’s responsibilities to administer
the credits are outlined in §142(a)(3) of H.R. 3200.
33 For more information on existing systems and laws
related to verification of immigration status, see CRS Report
R40144, State Medicaid and CHIP Coverage of Noncitizens, by Ruth
Ellen Wasem.
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