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Federal and State Laws Vary with Regard to Public Benefits for Certain Immigrants

Ambulance_NYC.jpgThe question of public benefits for immigrants is both complicated and controversial. State laws may be considerably different from federal law, even with regard to federal programs like Medicaid. A recent decision by the Ninth Circuit Court of Appeals, Korab v. Fink, No. 11-15132, slip op. (9th Cir., Apr. 1, 2014), addressed a Hawaii statute and affirmed that states have rather wide latitude under federal law to limit certain immigrants’ access to Medicaid coverage, or to exclude them entirely. New Jersey generally follows the federal system, while the state of New York offers wider Medicaid access to many immigrants.

The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, often known as the Welfare Reform Act, made substantial changes to non-citizens’ ability to apply for and receive public assistance. See 8 U.S.C. § 1601 et seq. “Qualified aliens,” defined to include permanent residents, asylees, certain parolees, and others, could still receive benefits, id. at § 1641(b), but others were barred. Exceptions are allowed for emergency medical care and services directly related to pregnancy. States could provide benefits at their own expense to non-qualified aliens, provided their legislatures passed new laws specifically authorizing such benefits. Id. at § 1621(d).

Some states passed legislation allowing non-qualified aliens access to benefits like Medicaid, even though those programs would not be eligible for federal reimbursement. Hawaii included many non-qualified aliens in its state health insurance plan until 2010. The state revised its plan to no longer include “COFA residents,” people who are nationals of the Republic of the Marshall Islands, the Federated States of Micronesia, or the Republic of Palau who reside in the U.S. under a Compact of Free Association (COFA). The COFA, codified at 48 U.S.C. § 1901, allows COFA residents to visit the U.S. without a visa and establish residence here, but they are not “qualified aliens” under PRWORA.

A group of COFA residents sued the state, claiming that dropping them from the state health plan and providing a separate plan created specifically for them with substantially less coverage violated the Equal Protection Clause. The Ninth Circuit ruled in Korab that, since the plaintiffs were not considered “qualified” under PRWORA, the state was within its authority to exclude them from the main health plan.

New Jersey applies the same basic criteria for eligibility as federal law for its state Medicaid program. Permanent residents are ineligible for Medicaid assistance during the first five years they hold that status, but certain other “qualified aliens,” such as refugees and asylees, may be able to qualify right away. Others are barred from coverage entirely. New Jersey’s appellate court affirmed the state’s authority, based on PRWORA, to exclude certain categories of immigrants from Medicaid coverage in Guaman v. Velez, 74 A.3d 931 (N.J. Super. 2013).

The New York Court of Appeals reached a different conclusion, holding that the the state and U.S. Constitutions barred a state law excluding permanent residents and other immigrants from state Medicaid coverage. Aliessa v. Novello, 754 N.E.2d 1085 (N.Y. App. 2001). New York allows permanent residents, meaning people with green cards, and others who are “permanently residing under color of law” (PRUCOL) to apply for state Medicaid. People who have received deferred status under the Deferred Action for Childhood Arrivals (DACA) program are considered PRUCOL.

Immigration lawyer Samuel C. Berger practices in the New York and New Jersey areas. We advise families and businesses on how to help immigrants come here, and we help immigrants obtain visas and green cards. To schedule a confidential consultation with a knowledgeable legal advocate, please contact us today online or at (212) 380-8117.

More Blog Posts:

Immigrant Advocates, Politicians Call for Cities to Reject Federal Immigration Detainers, New York & New Jersey Immigration Lawyer Blog, August 20, 2014
Federal Government Allows Extension of DACA Status, Amid Efforts to Roll Back the Program, New York & New Jersey Immigration Lawyer Blog, August 6, 2014
Immigration Detainers are Not Binding on Local Law Enforcement, According to Third Circuit Court of Appeals, New York & New Jersey Immigration Lawyer Blog, March 5, 2014
Photo credit: By Eyone [CC BY-SA 2.5], via Wikimedia Commons.