Affordable Care Act regulations specifying which immigrants are considered lawfully present and eligible to access the state and federal healthcare exchanges. Lawfully present immigrants are also eligible for some state funded benefits including health care for children, pregnant persons and/or abused immigrants in many states.
Publisher: Dept. of Health and Human Services
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[pdf] HHS Final Rule Clarifying the Eligibility of Deferred Action for Childhood Arrivals (DACA) Recipients and Certain Other Noncitizens for a Qualified Health Plan through an Exchange, Advance Payments of the Premium Tax Credit, Cost-Sharing Reductions, and a Basic Health Program (May 8, 2024) (+)
This document contains the regulatory history and the regulations delineating which noncitizens are eligible to purchase health insurance thorough the health care exchanges. The effective date of the regulations is November 1, 2024.
[pdf] HHS OTIP -Child Eligibility Benefits Handout (February 20, 2024) (+)
HHS Office on Trafficking in Persons Child Eligibility Handout updated and expanded February 20, 2024 provides an overview of the benefits and services available to help immigrant child trafficking victims who have received HHS child eligibility letters. It includes useful links and telephone numbers, steps children with OTIP letters have to take to obtain social security numbers required by some benefits granting agencies, how to apply for public benefits and how to present evidence of age and date of birth.
[pdf] Q & A: Immigrants (May 20, 2019) (+)
HHS, Administration for Children & Families, OFFICE OF FAMILY ASSISTANCE publication describing immigrant and citizen eligibility for TANF and which HHS funded programs are not subject to immigrant restrictions.
[pdf] HHS Public Health and Safety from Violence and Abuse Webpage (2.27.15) (+)
[pdf] HHS Domestic Violence Fact Sheet (6.8.2020) (+)
[pdf] OTIP NJN Webinar PowerPoint Presentation (October 10, 2023) (+)
[pdf] NJN PowerPoint Presentation (May 2, 2023) (+)
[pdf] HHS and Department Of Agriculture, Policy Guidance Regarding Inquiries into Citizenship, Immigration Status and Social SecurityNumbers in State Applications for Medicaid, State Children’s Health Insurance Program (SCHIP),Temporary Assistance for Needy Families (TANF), and Food Stamp Benefits (July 26, 2013) (+)
This is the July 2013 update of a publication originally issues in 2001 clarifying when in the context of public benefits applications, state and federal government agencies administer public benefits programs can and cannot inquire into the citizenship, immigration status, or social security number of an applicant. This publication specifically addresses who may and may not be asked for this information in cases where the applicant is a U.S. citizen child. Prior versions of this policy were issued in 2001 and 2006. All are available in the NIWAP library.
[pdf] HHS: Instructions Requests for Assistance for Child Victims of Human Trafficking (Current as of 2022) (+)
Provides instructions that professionals working with immigrant children who are victims of human trafficking (sex or labor) can us to file requests for assistance with HHS. These requests for assistance lead to issuance of child eligibility letters that make immigrant trafficked children eligible for federal and state public benefits to the same extent as refugees. Children must apply while they are under the age of 18. Eligibility letters once issues do not end and last until the child can apply for and be granted a T visa or lawful permanent residency through another form of immigration relief.
[pdf] Issuance of Child Eligibility Letters on or after Applicant’s 18th Birthday if Application Received Prior to 18th Birthday (May 11, 2016) (+)
Program Instruction for HHS, Administration on Children and Families, Office on Trafficking in Persons (OTIP) explaining that when children file Requests for Assistance while the child is under the age of 19, if the child turns 18 during the HHS eligibility determination process and/or receives their HHS eligibility letter after they turn age 18, they remain able to receive and use the HHS eligibility letter indefinitely as a basis to receive federal and state public benefits to the same extent as refugees.
[pdf] Office on Trafficking in Persons Child Certification Handout (+)
This handout created by the Administration for Children and Families Office on Trafficking in Persons explains how to use a certification letter to obtain benefits and services.
[pdf] Office on Trafficking in Persons Adult Certification Handout (+)
This handout created by the Administration for Children and Families Office on Trafficking in Persons explains how to use a certification letter to obtain benefits and services.
[pdf] HHS Domestic Violence Fact Sheet: Access to HHS-Funded Services for Immigrant Survivors of Domestic Violence (August 22, 2012) (+)
Discussing the range of HHS funded services and assistance for domestic violence victims that immigrant survivors can access. Covers assistance open to all persons without regard to immigration status, programs that are open to qualified immigrants (e.g. VAWA self-petitioners, battered spouse waiver applicants), Immigrant survivor access to federal means-tested public benefits, obtaining non-work social security numbers, and battered immigrant deeming exemptions.
[pdf] HHS Administration for Children and Families Trafficking Victim Child Certification Handout (November 6, 2020) (+)
[pdf] HHS Administration for Children and Families Trafficking Victim Adult Certification Handout (November 6, 2020) (+)
HHS handout for trafficking victims explaining how to use the HHS certification letter to obtain public benefits.
[pdf] Policy Guidance Regarding Inquiries into Citizenship, Immigration Status and Social Security Numbers in State Applications for Medicaid, State Children’s Health Insurance Program (SCHIP), Temporary Assistance for Needy Families (TANF), and Food Stamp Benefits (2006) (+)
This policy regarding inquiries into citizenship and immigration status by state officials administering Medicaid, SCHIP< TANF and Food Stamps was first issued in 2006 and was updated and reissued in 2013.
[pdf] Low-Income Home Energy Assistance Information Memorandum (2014) (+)
The memorandum provides guidance on how LIHEAP grantees use social security numbers and citizenship status information to provide assistance to applicants.
[pdf] Joint Letter from HUD, HHS, ad DOJ on Immigrant Access to Shelter and Transitional Housing (Aug 2016) (+)
[pdf] Emergency Shelter and Transitional Housing for Immigrant Victims: Government Policies (February 10, 2017) (+)
This document brings together in one collection the polices issued by federal government agencies describing the legal rights of immigrant and Limited English Proficient (LEP) victims of domestic violence, sexual assault, dating violence, stalking, human trafficking, child abuse, and the homeless to access emergency shelters and transitional housing from a wide array of programs offering these services who receive federal funding. The federal agency policies in this collection include policies issued by:
The U.S. Department of Justice (Office of Victims of Crime, Office on Violence Against Women)
The Health and Human Services (Family Violence Prevention)
The U.S. Department of Housing and Urban Development
These policies provide the requirements for providers of emergency shelter, transitional housing and other programs offering services necessary to protect life and safety. this packet of policies will help advocates and attorneys working with immigrant survivors and immigrant children gain access to housing, services and assistance they are eligible to receive without regard to their immigration or LEP status.
[pdf] Services Available to Victims of Human Trafficking: A Resource Guide for Social Services Providers (2012) (+)
Provides an overview of the state and federally funded benefits and services available to victims of human trafficking. Includes access to public benefits offered by HHS, USDA, HUD, USDOJ, SSA, DOL, and DOE (Education).
[pdf] FAQ Access to FYSB-funded Services for Survivors of Domestic Violence _ Family and Youth Services Bureau _ Administration for Children and Families (2016) (+)
The document confirms that immigrant victims have access to HHS Family Violence Prevention Act funded services including shelter and intermediate/transitional housing. It also discusses that anti-discrimination laws that apply.
[pdf] HHS Cover Letter to FVPSA Grantees (2016) (+)
Cover letter to Tri-agency letter on immigrant access to services necessary to protect life and safety including shelter and transitional housing and crisis counseling and intervention.
[pdf] Triagency Letter: Citizenship Immigration Status and Social Security Numbers (January 21, 2003) (+)
Letter from HHS and the U.S. Department of Agriculture: Policy guidance regarding inquiries into citizenship, immigration status, and social security numbers in state applications for medicaid, State Children’s Health Insurance Programs (SCHIP), Temporary Assistance for Needy Families (TANF), and food stamp benefits. Approved for distribution by OMB. Form Approved OMB# 0990-0379 Exp. Date 9/30/2020
[pdf] Domestic Violence Fact Sheet: HHS (2012) (+)
Update of Domestic Violence Fact Sheet: Access to HHS-Funded Services for Immigrant Survivors of Domestic Violence (2012)
[pdf] HUD-HHS-DOJ-Letter-Regarding-Immigrant-Access-to-Housing-and-Services (+)
This letter reiterates long standing federal policies that immigrants cannot be denied access to certain services necessary to protect life and safety based on their immigration status.
This letter reiterates that immigrants experiencing homelessness, victims of domestic violence, sexual assault, dating violence, stalking or human trafficking may not be turned away on the basis of immigration status from life and safety services including but not limited to emergency shelters, and short-term housing assistance (including transitional housing and rapid re-housing), crisis counseling and intervention, soup kitchens, community food banks, emergency Medicaid and public health services.
Importantly, this Tri-Agency letter describes the anti-discrimination requirements that apply to all federal grantees and the application of these protections to cases involving immigrants
[pdf] Federal Register: Health and Human Services: Final Rule Non-Discrimination in Health Care Access (July 18, 2016) (+)
Federal Register issue on the Health and Human Services department on the topic of nondiscrimination in federal health programs, services, and activities.
[pdf] Centers for Medicare and Medicaid Services (CMS): Medicaid and CHIP Coverage of “Lawfully Residing” Children and Pregnant Women (2010) (+)
A memo that provides guidance on the implementation of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 11-3. Section 214 of CHIPRA permits states to cover certain children and pregnant women in both Medicaid and the Children’s Health Insurance Program (CHIP) who are “lawfully residing in the United States” as described in section 1903(v)(4) and 2107(e)(1)(J) of the Social Security Act.
[pdf] Head Start Programs Memo (+)
Clarification of policy regarding verification of the citizenship and immigration status of Child Care and Development Fund (CCDF) applicants when non-profit organizations determine eligibility for the CCDF program and when a child receives combined CCDF and Head Start services.
[pdf] U.S. Departments of HHS and Agriculture: Q&A Re: Citizenship and Immigration Status Policy Guidance (March 24, 2006) (+)
U.S. Department of HHS and Agriculture: Policy guidance regarding inquiries into citizenship, immigration status and social security numbers in state applications for medicaid, state children’s health insurance program (SCHIP), temporary assistance for needy families (TANF), and food stamp benefits.
[pdf] Q&A: Five-Year Bar (2004) (+)
This document contains questions and answers regarding immigrants and the five-year bar. Section 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) provides that certain immigrants who enter the United States on or after August 22, 1996 are not eligible to receive federally-funded benefits, including Medicaid and the State Children’s Health Insurance Program (SCHIP), for five years from the date they enter the country with a status as a “qualified alien.”
[pdf] Q&A on the Five-Year Bar (+)
This document pertains to the Department of Health and Human Services Centers for Medicare and Medicaid Services’ questions and answers on the five-year bar. Section 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) provides that certain immigrants who enter the United States on or after August 22, 1996 are not eligible to receive federally-funded benefits, including Medicaid and the State Children’s Health Insurance Program (SCHIP), for five years from the date they enter the country with a status as a “qualified alien.”
[pdf] Policy Guidance RE: Citizenship, Immigration Status, and Social Security Numbers (January 21, 2003) (+)
Policy guidance regarding inquiries into citizenship, immigration status, and social security numbers in state applications for Medicaid, State Children’s Health Insurance Programs (SCHIP), Temporary Assistance for Needy Families (TANF), and food stamp benefits. Updated in 2006 and July 26, 2013.
[pdf] Access to HHS Funded Services for Immigrant Survivors of Domestic Violence Fact Sheet (+)
The Office for Civil Rights created this fact sheet on “Access to HHS funded Services for Immigrant Survivors of Domestic Violence” in an effort to educate domestic violence service providers, immigrant advocates, health and social service providers, benefits agency eligibility workers, and others regarding the complex web of eligibility rules issued by several different Federal agencies, including the U.S. Department of Health and Human Services and the US Department of Justice.
[pdf] Title VI of the Civil Rights Act of 1964; Federal Register – Policy Guidance on the Prohibition Against National Origin Discrimination As It Affects Persons With Limited English Proficiency (+)
The Department of Health and Human Services’ policy guidance on Title VI of the Civil Rights Act of 1964 for limited English proficient individuals.
[pdf] Clarification of Interpretation of “Federal Public Benefit” Regarding Child Care and Development Fund (CCDF) Services (+)
Title IV also requires providers of “Federal public benefits” to verify the immigration and citizenship status of all applicants, except for eligibility determinations made by non-profit charitable organizations. On September 23, 1998, the Administration for Children and Families (ACF) sent all Child Care and Development Fund (CCDF) Lead Agencies a letter about the August 4, 1998, Federal Register notice that listed the CCDF among the programs administered by the Department of Health and Human Services (HHS) that are subject to the verification requirements applicable to programs offering “Federal public benefits.” In that letter ACF said that it was considering how the “Federal public benefits” requirements related to the CCDF. After further research, ACF is offering additional guidance contained in this document.