What Immigrants Need to Know About the New ACA Eligibility Restrictions

Last year, Congress passed a bill making changes that will make health coverage less affordable and worsen health and financial inequities for immigrant families. Starting November 1, 2026, when open enrollment for the Affordable Care Act coverage begins, many previously eligible immigrants will lose ACA tax credits and cost-sharing help and may be unable to afford full-price coverage.

Marketplace enrollees should review their 2027 renewal information carefully. Those who selected automatic renewal could be automatically re-enrolled at a much higher monthly cost. Affected immigrants may receive information from their marketplace or health insurance plan about these changes.

Which immigrants are losing eligibility for ACA subsidies?

The new law means fewer categories of immigrants can get help buying health insurance through the ACA Marketplaces.

The categories of noncitizens who remain eligible for ACA subsidies are:

• Green-card holders (lawful permanent residents)
• Certain Cuban and Haitian entrants
• Citizens of the Freely Associated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau residing in the United States
• All other lawfully present immigrants will lose eligibility for financial support, including:
• Refugees; asylum applicants and recipients; people who applied for or received withholding of removal/deportation
• Survivors of violence petitioning for lawful status under the Violence Against Women Act
• T visa holders, bona fide applicants for T visas, and U visa holders (survivors of crime and trafficking)
• People paroled into the U.S. for more than one year and certain Afghan and Ukrainian parolees
• Green-card applicants
• Applicants for Temporary Protected Status with work authorization and TPS holders
• People granted Deferred Enforced Departure or deferred action (other than DACA)
• People who have petitioned for or received Special Immigrant Juvenile classification
• Individuals granted Continued Presence
• Certain immigrants with work authorization, including nonimmigrants in “compelling circumstances,” applicants for registry, applicants for adjustment under the LIFE Act, applicants for cancellation of removal/suspension of deportation, individuals under orders of supervision
• Lawful temporary residents and applicants for legalization
• Individuals with Family Unity

These changes affect financial assistance, but do not affect eligibility to enroll in marketplace coverage. Immigrants who are uncertain about their eligibility should seek help before assuming they must pay the full cost.

What information should immigrants expect from the ACA Marketplace?

Your experience will depend on whether your state runs its own marketplace or uses the federal marketplace. Find your state’s marketplace here. Marketplace processes, open enrollment timelines, and notices may vary by state. Immigrants may receive notices requiring prompt attention before or during open enrollment.

The federal government has indicated that marketplace enrollment websites will show the new subsidy rules and that current enrollees should receive advance notice of eligibility changes.

Immigrants who have marketplace coverage should:

• Update your marketplace application during open enrollment with documents showing your current immigration status. Open enrollment for 2026 runs from November 1, 2026, through January 15, 2027.
• Watch carefully for mail, email, text messages, or online account notices from the federal or state marketplace, your health insurance company, or the company or organization that helped you enroll.
• Respond promptly to requests for documentation or verification.
• Check the amount of your monthly premium before letting a plan renew automatically at a higher price.
• Review any termination or eligibility notices closely to determine the reason for the action.
• Contact local help or call the marketplace call center, which offers multilingual interpreters, if you need help understanding the changes and whether you can still get health insurance.

If the marketplace incorrectly finds you ineligible for coverage or assistance, respond by the notice deadline. You may be able to correct information, submit documents, or appeal. If your health insurer sends a termination or premium notice, contact the marketplace or an enrollment assister to confirm whether your subsidy eligibility has changed.

What health care options still exist if health insurance becomes unaffordable?

People who were eligible before may still buy full-cost marketplace plans, but many will not be able to afford premiums that can exceed $1,000 a month for a family of four. Losing subsidies or being unable to afford a marketplace plan does not mean you should stop seeking medical care.

Depending on where you live, options for care may include:

• State coverage that is available for people regardless of immigration status or for immigrants excluded from federally funded Medicaid. A detailed list of states that provide this funding is here.
• Federally Qualified Health Centers, which provide primary and preventive care regardless of immigration status and offer sliding-scale fees based on income
• Hospital charity care and financial assistance programs, which may reduce or eliminate medical bills for eligible patients
• Local public health programs, which provide vaccinations or treatments for various diseases at no cost and without immigration restrictions

Can Congress repeal these harmful restrictions?

Yes! And Congress should. These restrictions and other recent changes will make health coverage and necessary care less affordable for immigrant families, forcing people to choose between premiums or basic needs. It remains essential for people to have accessible, affordable health care. The government should be working to keep us healthier and safer, not making us sicker.

Advocates, health care providers, and community organizations will continue helping families navigate these changes. Affected immigrants should watch for Marketplace communications and seek trusted help before assuming affordable coverage is unavailable.