National Immigration Law Center
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Our mission is to defend & advance the rights & opportunities of low-income immigrants and their family members.

Health Care Reform Toolkit




Five Years is a Lifetime for Anyone to Wait for Health Care

Amid all the discussion and unfounded controversy about undocumented immigrants and health care, we often forget that current laws prevent even taxpaying, legal immigrants from obtaining affordable health care. 

Why hasn’t Congress removed the five year waiting period for lawfully present immigrants in federal health care programs like Medicaid? This is an essential reform in health care for immigrant communities. In these difficult economic times, when many of us are losing our health insurance, everyone should be able to rely on our nation’s safety-net programs, especially anyone whose taxes are helping to fund these programs.

What is the Five Year Waiting Period? 

Only certain legal immigrants, known as “qualified” immigrants, are eligible for Medicaid and CHIP. After lawfully entering the U.S., most of these immigrants who are income eligible for Medicaid or CHIP are forced to wait five years before they can enroll. This five year waiting period was removed recently when Congress passed the Children’s Health Insurance Program Reauthorization Act of 2009, but only for lawfully residing children and pregnant women (not for other adult immigrants) and only if a state chooses to do so.

Who Are These Immigrants?

  • Immigrants come here to pursue the American Dream -- to work hard, reunite with family and have the opportunities to live a better life that America offers.

  • Many immigrants have family members who are citizens. Legal immigrants are on a path to citizenship and will become U.S. citizens.  

  • Immigrants work and pay taxes but are disproportionately uninsured because they work in industries or small businesses that do not offer health care coverage.

  • Citizen children of immigrants often remain uninsured because of our complex rules regarding which family members may be eligible for affordable health care coverage. If we want to cover more Americans, we need to simplify the rules for everyone.

Why Eliminate the Waiting Period for Health Care for Immigrants

  • A waiting period for health care makes no sense and is fundamentally unfair. Immigrants are part of the American fabric and are contributing just like other everyone else.

  • If Congress ends the waiting period, then states would get immediate federal fiscal relief.

    • Based on sound health and economic policy reasons, many states invest state funds to provide affordable coverage to its residents who are legal immigrant adults in Medicaid without waiting periods: CA, CT, DE, DC, IL, ME, MA, MN, NE, NJ, NM, NY, WA.

    • At most, about 350,000 legal immigrants nationwide may be potentially eligible for Medicaid, if the five year waiting period is eliminated.   

    • The federal government should pay its fair share of the cost of affordable health care coverage for legal immigrants who are paying federal taxes.

    • Immigrants facing a five year waiting period still need care, but remain uninsured without access to affordable care. As a result, they are forced to delay care, turning simple problems into more complex and costly emergencies.  

    • Federal waiting periods simply shift the cost of care to individuals, local and state governments in the short-term, and add long-term costs in terms of loss of productivity and poor health outcomes for our future citizens.    

  • There’s no basis to keep the five year waiting period

    • The majority of the American public supports eliminating the five year waiting period for legal immigrants.

    • The Tri-Caucus in the House of Representatives  included the elimination of the five year waiting period as a priority in health care reform in order to achieve health equity for minorities.

    • Many in Congress support eliminating the five year waiting period, but need to hear from all of us who believe waiting periods are fundamentally unfair!

    • Congress recently gave states an option to eliminate the waiting period for legal immigrant children because they understood that five years is a lifetime to a child. Five years is a lifetime for anyone when it comes to access to affordable health care.  

  • The five year waiting period is an arcane rule based on a myth

    • Immigrants come here for work opportunities, education, to be with family and to live the American Dream. They do not immigrate to get health care and there is no such thing as “free” health care in the U.S.

    • No one deserves to wait for health care if they need it, let alone five years, especially when their taxes are helping to pay for health care for everyone else.

    • Health care reform needs to break down barriers like the five year waiting period in a new 21st century, fair, affordable health care system.