ACA Marketplace Coverage for Immigrants in 2026
The Affordable Care Act (ACA) Marketplace, also called the Exchange or Obamacare, is the main source of subsidized private coverage for lawfully present immigrants who do not qualify for Medicaid or Medicare.
Who Can Buy ACA Plans
Any lawfully present immigrant can purchase an unsubsidized plan through the ACA Marketplace. The question is whether you qualify for the premium tax credits (PTCs) that make coverage affordable.
As of January 1, 2026, lawfully present immigrants must have income at or above 100% of the FPL to receive premium tax credits. Previously, immigrants in the five-year Medicaid waiting period could receive credits even with income below 100% FPL. That rule is gone.
ACA Income Limits for 2026
For the 2026 plan year, premium tax credits are available to households earning between 100% and 400% of the FPL. The "subsidy cliff," where subsidies cut off at 400% FPL, returned in 2026 after enhanced credits expired.
| Household Size | 100% FPL (minimum for subsidies) | 400% FPL (maximum for subsidies) |
|---|
| 1 person | $15,650 | $62,600 |
| 2 people | $21,150 | $84,600 |
| 3 people | $26,650 | $106,600 |
| 4 people | $32,150 | $128,600 |
| 5 people | $37,650 | $150,600 |
| 6 people | $43,150 | $172,600 |
| 7 people | $48,650 | $194,600 |
| 8 people | $54,150 | $216,600 |
| Each additional person | +$5,500 | +$22,000 |
These figures are based on the 2025 HHS Federal Poverty Guidelines and apply to the contiguous 48 states. Alaska and Hawaii have higher thresholds.
DACA Recipients in 2026
DACA recipients lost access to ACA Marketplace enrollment as of August 25, 2025. If you have DACA status, you cannot purchase a plan through HealthCare.gov or a state Marketplace. You may still qualify for state-funded programs (see below) or employer-sponsored coverage.
Coming Changes in 2027
Starting with the 2027 plan year (open enrollment in fall 2026), eligibility for premium tax credits will narrow further. Refugees, asylees, TPS holders, and several other immigration statuses will lose access to PTCs. Only US citizens, lawful permanent residents, Cuban and Haitian entrants, and COFA migrants will remain eligible. If your status falls outside those groups, the open enrollment period in fall 2026 may be your last opportunity to secure subsidized coverage before 2027 changes take effect.
Medicaid Eligibility for Immigrants
Medicaid provides free or very low-cost coverage for people with low incomes. For immigrants, eligibility depends on both income and immigration status.
The Five-Year Waiting Period
Most immigrants who become lawful permanent residents must wait five years before enrolling in federal Medicaid. This applies to green card holders who entered after August 22, 1996.
Exceptions to the five-year bar include:
- Refugees and asylees (qualify immediately, for a limited period after arrival)
- Veterans and their families
- Survivors of trafficking with a T visa
- Amerasian immigrants
- Cuban and Haitian entrants (eligible immediately in most states)
State Options to Waive the Waiting Period
States have the option to cover certain immigrant groups using state funds even during the federal five-year bar. As of 2026:
- 38 states waive the waiting period for lawfully present immigrant children
- 32 states waive it for lawfully present pregnant immigrants
If you are a child or pregnant and you have lawful status, check your state's Medicaid rules. You may qualify without waiting five years.
Medicaid Income Limits (Expansion States)
In states that expanded Medicaid under the ACA, adults with income up to 138% of the FPL qualify, approximately $20,197 for one person or $41,568 for a family of four. You must also meet the immigration status requirements above.
For non-expansion states, Medicaid for adults is much more limited and generally tied to specific categories (parents with dependent children, people with disabilities, and similar groups).
Check the full state-by-state breakdown at CoveredUSA Medicaid income limits.
CHIP for Immigrant Children
The Children's Health Insurance Program (CHIP) covers children in families with income too high for Medicaid but who still cannot afford private insurance. Like Medicaid, CHIP has an immigration status requirement, but many states waive it for children.
As of 2026, lawfully present immigrant children can enroll in CHIP in most states without waiting five years. Income limits vary by state but typically range from 200% to 300% of the FPL, covering families with annual income between roughly $42,300 and $63,450 for a family of three.
Emergency Medicaid
Emergency Medicaid is a federal program that covers treatment of emergency medical conditions for people who meet all Medicaid financial and residency requirements but do not meet the immigration status requirement. This means it is the main safety net for undocumented immigrants.
Emergency Medicaid covers care like emergency room visits, surgery, labor and delivery, and treatment for acute conditions. It does not cover routine care, preventive visits, or ongoing treatment for chronic conditions.
Important change starting October 1, 2026: States will receive reduced federal matching funds for Emergency Medicaid, which may lead some states to limit what they cover or tighten eligibility rules. Check with your state Medicaid agency for the latest rules in your area.
State-Funded Programs for Undocumented Immigrants
A small number of states have created their own programs using state-only funds to cover income-eligible adults regardless of immigration status. As of 2026, these states provide some level of full coverage to undocumented adults:
| State | Program | Notes |
|---|
| California | Medi-Cal | New enrollments for undocumented adults 19+ frozen starting January 2026; existing enrollees keep coverage |
| Colorado | State program | Coverage continues for eligible adults |
| Illinois | Illinois Medicaid | Subject to budget discussions; verify current status |
| Minnesota | MinnesotaCare | State-funded option for income-eligible immigrants |
| New York | Essential Plan | Lawfully present immigrants with income under 200% FPL |
| Oregon | Oregon Health Plan | Expanded to cover adults regardless of status |
| Washington | Apple Health | State option for certain immigrant groups |
Budget pressures have led California, Illinois, and Minnesota to scale back or freeze new enrollments. Contact your state Medicaid office to confirm current eligibility rules before applying.
Employer-Sponsored Insurance
If you work for an employer that offers health benefits, you are generally eligible to enroll regardless of immigration status, as long as you are legally authorized to work. Green card holders, TPS holders, H-1B visa holders, and many others can and should enroll in employer plans during open enrollment.
Employer plans are often the most affordable option because the employer covers part of the premium. If your employer offers coverage and you decline it, you may not qualify for ACA subsidies.
Community Health Centers and Free Clinics
For immigrants who cannot access Medicaid or ACA plans, federally qualified health centers (FQHCs) provide primary and preventive care on a sliding-fee basis. FQHCs must serve patients regardless of ability to pay and regardless of immigration status.
Find a health center near you at findahealthcenter.hrsa.gov, or call 1-877-464-4772.
How to Apply for Coverage in 2026
Step 1: Identify your immigration status category
The biggest factor in your eligibility is your immigration status. Review the categories above and confirm where you fall: lawfully present, in a five-year waiting period, or undocumented.
Step 2: Estimate your household income
Use your expected gross income for the 2026 calendar year. Include all household members who file taxes together. Compare your income to the FPL table above to see where you fall.
Step 3: Check whether your state expanded Medicaid
If you are lawfully present and have income under 138% FPL, Medicaid in expansion states is the best option. Use the CoveredUSA eligibility screener to check both Medicaid and ACA eligibility at the same time.
Step 4: Compare your options
If you do not qualify for Medicaid, look at ACA Marketplace plans during the open enrollment period (November 1 through January 15 in most states). Compare plan costs, deductibles, and networks. Silver plans offer the best cost-sharing if your income is between 100% and 250% FPL.
Step 5: Apply
- ACA Marketplace: Apply at HealthCare.gov or your state's Marketplace
- Medicaid: Apply through your state Medicaid agency or through HealthCare.gov (they screen for both)
- State programs: Apply directly through the state agency listed above
- FQHCs: No application needed; walk in or call to schedule
Check your eligibility now at CoveredUSA. It takes 2 minutes. Visit coveredusa.org/screener to get your results.
Key Changes to Know for 2026
| What Changed | Effective Date | Who Is Affected |
|---|
| Immigrants below 100% FPL lose ACA subsidies | January 1, 2026 | Lawfully present immigrants with income under 100% FPL |
| DACA removed from Marketplace | August 25, 2025 | DACA recipients nationwide |
| Reduced federal Medicaid match for emergency services | October 1, 2026 | Undocumented immigrants relying on Emergency Medicaid |
| Refugees and asylees lose ACA subsidies | Plan year 2027 (fall 2026 enrollment) | Refugees, asylees, TPS holders |
| California freezes new undocumented enrollments | January 2026 | Undocumented adults 19+ in California |
Frequently Asked Questions
Can a green card holder get health insurance through ACA in 2026?
Yes. Lawful permanent residents (green card holders) can purchase ACA Marketplace plans at any income level. If your income is between 100% and 400% of the FPL, you also qualify for premium tax credits. If you have held your green card for at least five years and your income is low enough, you may qualify for Medicaid instead, which is usually free or nearly free.
Do immigrants have to wait five years for Medicaid?
Most lawful permanent residents must wait five years after receiving their green card before enrolling in federal Medicaid. However, many states waive this waiting period for children and pregnant immigrants. Refugees, asylees, and certain trafficking survivors are exempt from the five-year wait entirely.
Can undocumented immigrants get health insurance in the US?
Undocumented immigrants cannot enroll in Medicaid, Medicare, CHIP, or ACA Marketplace plans using federal funds. Emergency Medicaid covers life-threatening emergencies. Seven states plus Washington DC have state-funded programs that cover some undocumented residents, but several are scaling back. Federally qualified health centers provide care on a sliding scale to anyone regardless of status.
Is DACA covered by health insurance in 2026?
No. DACA recipients lost access to ACA Marketplace plans on August 25, 2025. If you have DACA status, check whether you qualify for a state-funded program in your state, whether your employer offers coverage, or whether a community health center near you provides affordable primary care.
What happens if I miss ACA open enrollment?
If you miss the annual open enrollment period (November 1 through January 15), you can only enroll through a Special Enrollment Period (SEP) triggered by a qualifying life event, such as losing job-based coverage, getting married, moving to a new state, or having a baby. Immigrants who are newly granted lawful status also qualify for a SEP. Apply within 60 days of the qualifying event.
Can I use the ACA Marketplace if I have a work visa?
Yes. Most work visa holders, including H-1B, L-1, O-1, and others, are considered lawfully present and can purchase ACA Marketplace plans. If your employer offers health coverage, you should enroll there first, since declining employer coverage may disqualify you from ACA subsidies. Compare both options during your employer's open enrollment period.
Will my immigration status affect my premium tax credit amount?
Not directly. The credit amount depends on your income relative to FPL and the cost of plans in your area. What matters for immigrants is first meeting the status threshold: being lawfully present and having income above 100% FPL in 2026. Once you meet those conditions, the credit calculation works the same as it does for citizens.
Where can I get help applying for immigrant health coverage?
Navigators and certified enrollment assisters at community health centers can help you apply for free. Many speak Spanish and other languages. Visit findahealthcenter.hrsa.gov to find a navigator near you, or use the CoveredUSA screener to check your options in two minutes before you apply.
