NCPA - National Center for Policy Analysis

Public Health-Care Assistance Varies for Legal Immigrants

September 4, 2001

A quirk in the federal welfare reform law passed in 1996 has left some legal immigrants eligible for health-care assistance while denying it to others. Some experts call it a legal minefield.

  • Tucked into the law was a ban on free federal medical care for new green-card holders during their first five years in the U.S.
  • The number of permanent legal residents subject to the ban has now reached some four million.
  • But Congress did give each state an option to offer some or complete Medicaid coverage to some or all new legal immigrants.
  • At their own expense, a dozen states have done so -- and local hospitals and clinics randomly take up the slack.

In June, New York's Court of Appeals declared the ban unconstitutional, basing its decision on its own state constitution. That constitution obliges government to extend Medicaid and other programs like it to all poor people -- so long as they aren't illegal immigrants. The court said it should make no difference when they arrived in the U.S.

But the situation is further complicated by a provision in the 1996 law that requires immigrants who apply for Medicaid after five years in residence to include the income of their sponsors as part of their own income -- which would make many of them too rich to qualify.

A survey by the Urban Institute last year found that fewer than half the states offer substitute health insurance for new immigrants.

Source: Barry Newman, "Quirk in Law Creates Health-Care Minefield for Legal Immigrants," Wall Street Journal, August 29, 2001.


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