Fact
The Affordable Care Act explicitly defines who is eligible for federal payments, credits or subsidies for health insurance coverage and makes clear that undocumented immigrants are ineligible.
Some have expressed concerned that undocumented immigrants will have the ability to receive subsidies for health insurance under the reform proposals in Congress. Senator Leahy does not support using government funding to subsidize insurance for those who have entered the United States illegally or who are residing in the United States in an undocumented status. The full text of the law clearly defines who is eligible for federal payments, credits or subsidies.
The relevant statutory language is below:
Patient Protection and Affordable Care Act
Subtitle D—Available Coverage Choices for All Americans
PART II–Consumer Choices and Insurance Competition Through Health Benefit Exchanges
- Section 1312 (f)(3) makes clear that undocumented immigrants are ineligible to participate in the health insurance exchanges: “ACCESS LIMITED TO LAWFUL RESIDENTS- If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.”
Subtitle E—Affordable Coverage Choices for All Americans
PART I—PREMIUM TAX CREDITS AND COST SHARING REDUCTIONS
Subpart B—Eligibility Determinations
- Section 1412(d) unambiguously states “NO FEDERAL PAYMENTS FOR INDIVIDUALS NOT LAWFULLY PRESENT.—Nothing in this subtitle or the amendments made by this subtitle allows Federal payments, credits, or cost-sharing reductions for individuals who are not lawfully present in the United States.”
The Act also establishes a fair process to accurately verify eligibility for participation in the benefits of health insurance reform that does not place unnecessary bureaucratic hurdles for U.S. Citizens nor undue administrative costs on the government.
Patient Protection and Affordable Care Act
Subtitle E—Affordable Coverage Choices for All Americans
PART I—PREMIUM TAX CREDITS AND COST SHARING REDUCTIONS
Subpart B—Eligibility Determinations
- Section 1411(a) required that the Secretary of Health and Human Services “shall establish a program . . . for determining . . . whether an individual who is to be covered in the individual market by a qualified health plan offered through an Exchange, or who is claiming a premium tax credit or reduced cost-sharing [is] a citizen or national of the United States or an alien lawfully present in the United States.”
- Section 1411(b) requires applicants for enrollment in a qualified health plan offered through an Exchange in the individual market to provide “name, address, and date of birth.” For those individuals claiming eligibility based on an attestation of citizenship, they must provide their social security number. For those individuals whose eligibility is based on an attestation of their immigration status, they must provide “the enrollee’s social security number (if applicable) and such identifying information with respect to the enrollee’s immigration status as the Secretary, after consultation with the Secretary of Homeland Security, determines appropriate.”
Senator Leahy has also heard from Vermonters with small businesses who employ seasonal workers and their concern about the requirement that employers purchase health insurance for their employees.
The Act exempts small businesses from the employer mandate to provide health insurance for employees, and employers are not subject to penalties if they employ 50 or fewer employees. Seasonal workers do not count towards the 50 employee threshold. And for those employers subject to the penalty, they are only responsible for providing health insurance for full-time employees.
Patient Protection and Affordable Care Act
Subtitle F—Shared Responsibility for Health Care
PART II—EMPLOYER RESPONSIBILITIES
Section 1513—Shared Responsibility For Employers
(B) EXEMPTION FOR CERTAIN EMPLOYERS-
(i) IN GENERAL- An employer shall not be considered to employ more than 50 full-time employees if—
(I) the employer’s workforce exceeds 50 full-time employees for 120 days or fewer during the calendar year, and
(II) the employees in excess of 50 employed during such 120-day period were seasonal workers.
(ii) DEFINITION OF SEASONAL WORKERS—The term `seasonal worker’ means a worker who performs labor or services on a seasonal basis as defined by the Secretary of Labor, including workers covered by section 500.20(s)(1) of title 29, Code of Federal Regulations and retail workers employed exclusively during holiday seasons.”