Health coverage when immigration status is part of the question
Immigration status changes what you are allowed to buy, and the rules changed again for 2027. What follows is what is actually true in Connecticut, New Jersey and Pennsylvania — including the parts that are not good news.
We are insurance brokers, not immigration lawyers. Anything that touches your own status is a question for an attorney. What we can do is tell you which door is yours.
What changed for 2027
Until this year most lawfully present immigrants could get help paying for a marketplace plan. From January 1, 2027 that help is limited to a much smaller group.
Premium help now goes only to U.S. citizens and nationals, green card holders, Cuban and Haitian entrants, and people here under a Compact of Free Association — the Marshall Islands, Palau and Micronesia.
Refugees, people with asylum, people with Temporary Protected Status and victims of trafficking are no longer in that group. They can still buy a marketplace plan. They pay the full price for it.
If that is you and you had help with your premium this year, next year’s bill will not look the same. That is worth working out before January rather than after. A green card changes the answer, so if one is in progress, say so.
This comes from the 2025 federal budget law, not from any insurer and not from us. Plenty of guidance still online was written before it passed and says the opposite.
Children: the three states are not the same
This is where the difference between Connecticut, New Jersey and Pennsylvania is largest, and it decides whether a child in your house can be covered at all.
Connecticut
HUSKY covers children under 15 regardless of immigration status, and has done since July 2024. Once a child is on it, coverage can continue to 19 as long as they still qualify. Connecticut
New Jersey
NJ FamilyCare covers children under 19 regardless of immigration status. The person filling in the form does not have to give their own status, and the child does not need a Social Security number. New Jersey
Pennsylvania
There is no equivalent. Both CHIP and Medical Assistance require a qualifying immigration status, and a child without one does not qualify. We would rather tell you that than let you find out at the application. Pennsylvania
If you are undocumented
The straight answer first: you cannot buy a marketplace plan, and you do not qualify for regular Medicaid. That is federal law and no broker can change it.
What is left is not nothing. Your children may still qualify in Connecticut and New Jersey, on their own, whatever your status. Pregnancy is covered in both of those states under the programs below. A hospital cannot refuse you emergency treatment because of your status or your ability to pay — that is federal law too.
Some people in this position buy coverage directly from an insurance company instead of through the marketplace. That is legal, there is no help with the premium, and whether it is worth the money depends entirely on the price and what it actually covers. We will tell you honestly when it is not worth it.
We are not paid when we point you at a state program, and we point you at one anyway when that is the right answer.
When not everyone in the house has the same status
This is the single most common reason families do not apply, and it is not a reason.
The people who are eligible can enroll even if others cannot. A child who qualifies qualifies, whatever the adults’ situation is.
A state cannot make someone who is not applying give their own immigration status. In New Jersey the person filling in the form does not have to give theirs at all, and a child without status does not need a Social Security number.
The public charge test applies to people applying for a visa, for entry to the country, or for a green card, and it concerns cash assistance and government-paid long-term care. It is immigration law, not insurance law, and it is a question for an immigration attorney — not for us, and not for anything you read on a website.
Pregnancy, and emergencies
Both of these work differently from ordinary coverage, and both reach further than people expect.
Connecticut runs a prenatal program for pregnant people who do not qualify for HUSKY because of immigration status, up to an income limit, and covers twelve months after the birth. New Jersey covers prenatal care regardless of status.
Emergency Medicaid exists in every state and immigration status is not part of it. It covers a sudden emergency, and it covers labor and delivery. There are income limits, it is not approved in advance, and it does not cover ongoing care for a long-term condition.
Pennsylvania does not have an equivalent program for people without a qualifying status. The emergency rules still apply there.
Common questions about coverage and immigration status
Can I get health insurance if I am undocumented?
Not a marketplace plan, and not regular Medicaid — federal law does not allow it. Three things are still open to you. Your children may qualify in Connecticut or New Jersey on their own, whatever your status. Pregnancy is covered in both of those states. And a hospital cannot refuse you emergency treatment because of your status. Buying a policy directly from an insurance company outside the marketplace is also legal, with no help toward the premium.
Are my children covered in Connecticut if we do not have papers?
Children under 15 qualify for HUSKY in Connecticut regardless of immigration status, and have since July 2024. Once a child is enrolled, coverage can continue to age 19 while they still qualify. New Jersey goes further and covers children under 19. Pennsylvania has no equivalent program, so a child without a qualifying status does not qualify there.
Does applying for HUSKY or NJ FamilyCare affect my immigration status?
A state cannot require someone who is not applying to give their own immigration status, and in New Jersey the person filling in the form does not have to give theirs at all. The public charge test applies to people seeking a visa, entry to the country, or a green card, and it concerns cash assistance and government-paid long-term care. That is immigration law rather than insurance law, and the right person to ask about your own case is an immigration attorney.
I am a refugee. Why did my help with the premium stop for 2027?
Because the 2025 federal budget law changed who qualifies. From January 1, 2027 premium help goes only to citizens and nationals, green card holders, Cuban and Haitian entrants, and people here under a Compact of Free Association. Refugees, people with asylum, Temporary Protected Status holders and victims of trafficking are no longer included. You can still buy a marketplace plan; you pay the full price. If a green card is in progress, that changes the answer, so it is worth telling us.
Can a family where some of us have status and some do not apply together?
Yes. The people who are eligible can enroll even if others in the household cannot, and the ones who cannot do not have to disclose their status to make that happen. A mixed-status household is an ordinary situation, not an obstacle.
I had help with my premium last year and I have none for 2027. Is that the status change?
It may be, and it may not — the two causes look identical on a renewal letter. From January 1, 2027 the premium tax credit is limited by status, and refugees, people granted asylum, people with Temporary Protected Status and trafficking victims are no longer covered by it. But a great many people lost help for a completely different reason: the temporary extra credit expired for everybody, and the 400% income cliff returned. Those two are often fixable. Status is not, but there is still coverage to arrange. The three reasons a 2027 premium went up.
Tell us the situation. You get a straight answer.
Who is in the house, who has what status, and what state you are in — that is enough to tell you which of you can be covered and how. If the answer is a state program rather than us, we will say so. Se habla español.