Updates:

• New Mexico should say yes to the Medicaid Opportunity! Starting in 2014, New Mexico can provide health coverage to 150,000 New Mexicans. It’s the deal of the century: the federal government will pay 100% of the costs of coverage for these newly insured for the first three years, and after 2020 will pay 90 cents for every 10 cents New Mexico pays. Over the next 7 years, there will be no net costs for our state because a 4% tax paid by insurance companies will cover the state’s share. Medicaid saves lives, and the new federal money creates tens of thousands of jobs. An estimated 4,000 lawfully present immigrants would qualify for Medicaid if the state takes this opportunity. Click here to learn more about the Medicaid Opportunity and to find out how you can get involved! (August 2012)
• Health Resource List for Immigrants: Are you looking for health care providers that serve immigrant patients for free or at a low cost? Check out the Center’s new health resource guide for immigrants in English and Spanish for a list of providers and programs across the state.
• Federal Health Reform and Immigrants: National groups have produced some new materials explaining how federal healthcare reform will affect immigrant families. Read the National Immigration Law Center’s factsheet for a basic overview.
• Medicaid Eligibility for Immigrant Children and Pregnant Women: New Mexico has new Medicaid eligibility rules for lawfully residing immigrant children and pregnant women. Previously, many immigrants had been subject to a five year waiting period (known as the “five year bar”) before they were eligible for Medicaid. Effective October 1, 2009, the state eliminated the five year bar for children younger than 21 and pregnant women. While undocumented immigrants still cannot qualify for Medicaid, immigrant children and pregnant women in any lawful status can now qualify for Medicaid immediately if they meet the income requirements. To find out if you are eligible for Medicaid under the new rules, contact your local ISD office or call us at (505) 255-2840.

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Immigrant Access to Healthcare

In New Mexico, there are a variety of healthcare resources for immigrants. It can be difficult to figure out where to go because the rules about immigration status and eligibility for public programs are so complicated. This page provides basic information about important resources such as Medicaid, hospital charity programs, county programs, and clinics and hospitals that provide free or low-cost health services for immigrants. If you need assistance with locating the right resources to meet your health needs, please call our office at (505) 255-2840.

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Immigrants and Health Reform

Medicaid and CHIP

Medicaid and the Children’s Health Insurance Program (CHIP) provide free or very low-cost health insurance to some low-income people. Currently, Medicaid coverage is limited to children, very low-income parents, people with disabilities, seniors, and women who are pregnant, seek family planning services, or have been diagnosed with breast or cervical cancer. Starting in 2014, the state has the opportunity to offer Medicaid coverage to nearly all adults with incomes below 138% of the federal poverty level. Click here to learn more about the Medicaid Opportunity.

Many immigrants can get Medicaid if they meet the income requirements. For example, children and pregnant women in any lawful immigration status can qualify for Medicaid immediately. Refugees, asylees, and victims of domestic violence can also qualify for Medicaid right away without a waiting period. All other lawfully residing immigrants, with the exception of children and pregnant women, may be required to wait for five years before enrolling in Medicaid. This chart, organized by immigration status, provides information on immigrant eligibility for New Mexico benefits programs.

Some immigrants worry that receiving Medicaid can harm their chances of obtaining lawful permanent residency (a Green Card) or U.S. citizenship. In general, it is safe for any lawfully present immigrant to use Medicaid. One important exception is that for some immigrants, enrolling in Medicaid for long-term institutional care can be used as evidence that a person is a “public charge” risk. For more information about immigrant eligibility for benefits programs, including the “public charge” test, visit our Immigrants and Benefits page.

Undocumented immigrants are not eligible for Medicaid or CHIP. However, many New Mexicans live in “mixed status” households. In these households, family members may have a variety of different immigration statuses –citizens, lawful permanent residents, undocumented immigrants, and other types of immigrants often live under one roof. It is important to remember that only the immigration status of the person applying for benefits matters. For example, citizen children are eligible for Medicaid and undocumented parents, grandparents, and other caretakers can apply for benefits on the children’s behalf. The parents do not have to provide proof of their own immigration status during this process. For more information about how to safely apply for benefits, visit our Immigrants and Benefits page.

Children’s Medical Services

The New Mexico Department of Health has a Children’s Medical Services program that covers children with certain chronic health conditions, regardless of immigration status.  These brochures in English and Spanish provide additional information.

Emergency Medical Services for Aliens (EMSA)

EMSA pays the cost of emergency medical care for people whose immigration status prevents them from qualifying for Medicaid. EMSA services are available only to people who meet all Medicaid eligibility criteria except for immigration status. EMSA covers the cost of emergency medical services, including labor and delivery, as long as you apply within 90 days of receiving the services. For more information about EMSA, see our fact sheets in English and in Spanish.

County Indigent Funds

Most counties in New Mexico have indigent funds devoted to helping low-income individuals and families pay the cost of medical bills. Most New Mexico counties assist patients regardless of immigration status. Bernalillo County does not have an indigent fund; instead, the University of New Mexico Hospital offers UNM Care. For more information about indigent funds, call your county offices and ask about their indigent care program.

Hospital Charity Care Programs

Many hospitals have charity care funds that help the low-income uninsured pay medical bills. If you receive care at any hospital and are worried about your ability to pay, you should ask whether the hospital has a charity care or financial assistance program. This page has information about some Bernalillo County hospital charity care programs, but there may be other hospitals in the state with similar programs.

University of New Mexico Hospital

UNMH offers a variety of financial assistance programs. UNM Care is a stand-in for health insurance that provides a “medical home” to the patient, with a primary care physician and specialist referrals. UNM Care is available to citizens and lawfully present immigrants who are residents of Bernalillo County and below 300% of the Federal Poverty Level.

While undocumented immigrants are not eligible for UNM Care, they can get help with certain types of medical bills. UNMH offers a 45% discount off of all hospital bills for the uninsured. UNMH also offers limited financial assistance to immigrants with incomes below 300% of the Federal Poverty Level who require services that are necessary for the treatment of an emergency medical condition, immunization, or to treat the signs or symptoms of a communicable disease. In addition, UNMH’s Maternity and Family Planning Clinic offers prenatal care to women, regardless of immigration status, on a sliding payment scale.

The Center has compiled a summary of the financial assistance available at UNMH. For information about how to apply for financial assistance with UNMH, call the Business Office at (505) 272-2521.

Presbyterian

Presbyterian Healthcare Services Financial Assistance provides free medically necessary services to patients with incomes up to 200% of the Federal Poverty Level. Patients with incomes between 200% and 300% of the Federal Poverty Level qualify for sliding-scale discounts. Financial Assistance through Presbyterian is available to anyone regardless of immigration status. To apply for financial assistance with Presbyterian, call (505) 923-6600 or 1-800-251-9292, or email pfsservice@phs.org. The Center has compiled a summary of the financial assistance available at Presbyterian.

Other Clinics and Health Centers that Serve Immigrants

There are many healthcare clinics and providers that provide free or discounted services to their patients, regardless of their immigration status. The Center has put together a resource list in English and Spanish of these health providers across the state. If you need more assistance with locating a resource, or know of any other resources that may be missing from this list, please call us at (505) 255-2840.

HEALTHCARE REFORM AND IMMIGRANTS

For lawfully present immigrants, federal healthcare reform – which goes into effect January 1, 2014 – both expands access to health insurance and creates an obligation to maintain coverage. Undocumented immigrants, on the other hand, are excluded from both the benefits and the mandate to get coverage under health reform. For a summary of how healthcare reform impacts immigrants, take a look at this factsheet put together by the National Immigration Law Center.

Lawfully Present Immigrants

Healthcare reform has the potential to expand access to care for low-income people in two major ways. First, the state has the opportunity to provide Medicaid to most adults with incomes up to 138% of the Federal Poverty Level (children in New Mexico are already covered up to 235% of the Federal Poverty Level.) Some immigrants, such as refugees, asylees, and victims of domestic violence, would also become eligible. But other immigrants, such as most adult Lawful Permanent Residents (LPRs or “green card” holders), would still have a five year waiting period before they could apply for Medicaid. An estimated 4,000 lawfully present immigrants in New Mexico could become eligible for Medicaid. To find out more about the Medicaid Opportunity, click here.

Second, the law provides financial assistance to help people purchase private health coverage. This financial assistance is in the form of tax credits (to help pay monthly premiums) and subsidies (to help keep the cost of copays and deductibles down). It is calculated on a sliding scale based on income, and is available to individuals up to 400% of the poverty level and to small businesses. To take advantage of the financial help, immigrants will have to purchase their coverage through the Exchange, an online marketplace that will offer an array of insurance options. To learn more about the Exchange, please visit our Healthcare Reform page.

Lawfully present immigrants are also subject to the individual mandate. This means that unless they are very low-income, they will have to pay a tax penalty at the end of the year if they fail to enroll in coverage.

Undocumented Immigrants

Undocumented immigrants are excluded from the benefits of health reform. They remain ineligible for Medicaid and are not permitted to purchase health insurance through the Exchange – even if they are willing to pay full price. Undocumented immigrants are also exempt from the individual mandate, so they do not have to pay a penalty for failing to maintain health insurance.

However, it is important to be aware that citizen children or lawfully present children of undocumented immigrants can still access premium tax credits and cost-sharing subsidies to help purchase coverage in the Exchange. This is available through an option called “child only” coverage. In addition, the children of undocumented immigrants may be eligible for Medicaid or CHIP. For information on how undocumented immigrants can safely apply for benefits for their eligible children, visit our Immigrants and Benefits page.

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Know Your Rights

Applying for Public Programs

Immigrants who apply for benefits should follow the same rules as anyone else applying. Our How to Apply for Benefits page can help you get started. However, there are some special additional considerations for immigrant families. Immigrants can encounter special problems with documenting income, for example. For information on how to safely apply for benefits, please visit our Immigrants and Benefits page. If you experience difficulties applying that cannot be resolved with ISD, please contact the Center for assistance at (505) 255-2840.

Language Access

If you do not speak, write, read, or understand English, you have a right to receive services in a language you understand when you apply for public benefits and if you are using any medical facility that accepts Medicare or Medicaid or receives other federal funding from the U.S. Department of Health and Human Services. Visit our Language Access and Public Benefits page to learn more about your right to an interpreter and to translated materials.

Emergency Care

Any patient who goes to an emergency department has a right to be provided with an appropriate medical screening examination to determine if she is suffering from an emergency medical condition. The Emergency Medical Treatment and Active Labor Act (EMTALA) prohibits hospitals from denying necessary emergency care, including delivery of a child for a woman in active labor, on the basis of a person’s inability to pay. A patient who needs emergency treatment cannot be transferred to another facility unless she requests transfer or has been stabilized. While the hospital can ask about the patient’s ability to pay, it cannot delay treatment to make the inquiry. The person will later receive a hospital bill from the emergency room visit. But in most cases, there are financial assistance or charity care programs for low-income people that pay the entire cost of emergency care.

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Our Advocacy on Immigrants and Healthcare

We are committed to expanding access to high-quality healthcare for immigrants in New Mexico. Our advocacy in this area includes:

• Working to ensure that New Mexico says yes to the Medicaid Opportunity, which would provide healthcare coverage to an estimated 4,000 lawfully present immigrants beginning in 2014. Visit our Medicaid Page to find out more about the Medicaid Opportunity.
• Ensuring immigrants who are eligible for Medicaid and CHIP can get enrolled in the programs by pushing for regulations and policies that reduce enrollment barriers.
• Encouraging hospitals to offer financial assistance programs that help all low-income patients, regardless of immigration status, and ensuring that they do a good job of publicizing these financial assistance options rather than sending immigrant patients to collections agencies when they cannot pay their bills.
• Monitoring the development of new Information Technology enrollment systems for the healthcare and public benefits systems to ensure they meet immigrant families’ unique language access and income verification needs.
• Working with the state and other stakeholders to advocate for the development of a comprehensive, culturally sensitive consumer assistance program under healthcare reform. This includes educating the state about the importance of training navigators – community assistors who will help New Mexicans understand their health coverage options and enroll in the plan that is best for them – in immigrant families’ needs.
• Keeping track of changes in federal law and advocating for parallel changes to state regulations so that state offices and hospitals are consistently applying federal requirements.
• Ensuring that application procedures at state offices and in hospitals and clinics request only the information that is necessary to process immigrant families’ applications. This includes making sure that forms do not request social security numbers or immigration status information for household members who are not requesting benefits for themselves.
• Ensuring that Medicaid and hospital programs make their services fully available to immigrant families, no matter what language they read or speak. Visit our Language Access page for more information on our language access advocacy.
• Conducting regular community outreach and trainings to spread the word about immigrants and healthcare and hear stories about barriers to accessing care. This work includes collaborating with legal services providers and other advocates to learn about recurring problems and barriers for immigrants. We use these stories to inform our continuing policy work.

The Center provides training to community groups and advocates to ensure that New Mexican immigrants know their rights and understand the health resources and benefits available to them. If you are interested in having the Center give a presentation to your group or organization, please contact Craig Acorn at (505) 255-2840 or by email at craig@nmpovertylaw.org. Please note that we can only arrange trainings for groups of 10 or more people.

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