Covered CA rules on
“Lawfully Present” Undocumented, Immigration Status, Residency  ^{45 CFR 152.2} 

Trump – Big Beautiful Bill Changes

Trump Big Beautiful Bill Changes

• Cuts for Lawfully Present Immigrants
• The GOP plan could cause at least hundreds of thousands of immigrants who are lawfully present — including asylum-seekers, victims of trafficking, and refugees — to lose their ACA marketplace coverage by cutting off the subsidies that make premiums affordable. The restriction won’t apply to green-card holders.
• Because the immigrants who will lose subsidies under the legislation tend to be younger than the overall U.S. population, their exit would leave an older, sicker, and costlier population of marketplace enrollees, further pushing up marketplace premiums, according to marketplace directors in California, Maryland, and Massachusetts and health analysts.
• Taking health care access away from immigrants living in the country legally “will do irreparable harm to individuals we have promised to protect and impose unnecessary costs on local systems already under strain,” John Slocum, executive director of Refugee Council USA, an advocacy group, said in a statement.
• The bill reflects the Trump administration’s restrictive approach to immigration. But because it ran afoul of Senate rules, the legislation doesn’t include a proposal that would have reduced federal Medicaid payments to states such as California that use their own money to cover immigrants without legal status.  KFF *  Politico.com *
• Megabill hits health care for immigrants, including legal ones, hard  
• HHS rescinds undocumented immigrant access to federal health benefits  

Lawful Presence 

More detail on lawful presence

•  
• 
• Tax Guide for Aliens Publication # 519
• .chcf.org language-other-than-english-listening-complex-needs/  
• New visa rules may bar obese people  LA Times  
  • Immigrants With Health Conditions May Be Denied Visas Under New Trump Administration Guidance  KFF.org 11/6/2025  
• Special Enrollment when it’s not Open Enrollment, like a change in lawful presence status
• List of Individuals with “Lawfully Present” Status for Eligibility and Enrollment Purposes in the Covered CA Exchange Individual Market  
  • covered ca.com/documents-to-confirm-eligibility/immigration-status/
  • Our webpage on proof of identity and income
    • Citizenship & Immigration Services USCIS.Gov
• Lawyers Guide to determine citizenship in Criminal Cases
  • Federal 8 U.S. Code § 1641 – Definitions for Medi Cal – Medicaid
  • Overview of Immigrant Eligibility for Federal Programs – National Immigration Law Center
• THE AFFORDABLE CARE ACT: COVERAGE IMPLICATIONS AND ISSUES FOR IMMIGRANT FAMILIES
• Chart comparing Immigration and Covered CA with Subsidies – Western Poverty Law
• USCIS Policy Manual
  • H 1 B H 2 programs
  • immigrant  guide.ca.gov/
• Employers should  prepare for Immigration Raids
  • Employers Face Looming Immigration Changes Under Trump Administration
    Experts warn of stricter enforcement, slower processing, and visa restrictions
  • Judge orders RFK Jr.’s health department to stop sharing Medicaid data with deportation officials  LA Times 8/14/2025
• Trump confirms deportation strategy will include national emergency declaration and military
  • Trump ally explains how mass deportations could work
  • organizations on this list are able to provide assistance regarding public charge.
  • Employers Face Looming Immigration Changes Under Trump Administration  Learn More >>>  SHRM
    • I 9 Compliance 

Technical and Research Resources

• Covered CA Q & A on Immigration Status
  • Immigrants 
• Health Care.gov on immigrants
  • Immigration Document Types
• Coverage and Issues for Immigrant Families – aspe.hhs.gov (pdf)
• Attorney Guide to determine Citizen Status in Criminal Cases
• Covered CA Webinar on verification of residency Proposed Regulations 5.2013
• immigration policy.org
• What if you are not lawfully present and you try to apply for coverage? Will it be reported to INS?
• FAQ’s Kaiser Foundation kff.org/immigrants
• New Obama Immigration may allow those to get Medi-Cal californiahealthline.org/2014/11/21
• 4 page – Immigration Status and Covered Ca hbex.coveredca.com

• For purposes of this part the following definitions apply:
  • Creditable coverage means coverage of an individual as defined in section 2701(c)(1) of the Public Health Service Act as of March 23, 2010 and 45 CFR 146.113(a)(1).
  • Enrollee means an individual receiving coverage from a PCIP established under this section.

8 US Code §1641 Definitions

Consumer Resources

• Citizenship & Immigration Services uscis.gov
• Publication 519 US Tax Guide 1040 for Aliens
• What you need to know – Covered CA 1 page pdf
• nilc.org/lawfullypresent/  National Immigration Law Center
• Western Poverty Law Center – Guide for Low Income CA to get coverage
• Here are samples of acceptable documents that Covered CA will accept as proof ♦
• If you do NOT qualify, you can try an International Policy 
• Covered CA Application ♦ 7 Page Worksheet to complete ONLINE Application
• Covered CA letter to CMS on new rules..??  4/11/2025
  • 2025 Marketplace Integrity and Affordability Proposed Rule 

See our main webpage on Medi Cal Information

H I S T O R I C A L

• Covered CA Toolkits

• Open Enrollment Tool Kit
  • Renewal Toolkit
• Enrollment Dashboard Guide for Certified Enrollers
  • Enroller Portal Consumer Retention Workspace (CRW) Quick Guide
• FPL Chart
• Strike & Lockout
• QLE  Major Life Changes
• Documents to Confirm Eligibility
  • Identity
  • Remote Identity Proofing
• Income Section
• Certified Agent Briefing  
• DACA Toolkit 
• social press kit.com/lets-talk-health
• Daily Summary Notices Broker Portal
• Medi Cal to Covered CA
• 2024 End of the year briefing
• Forms - Including Paper Application
• 1095  toolkit
• how to generate and print plan summaries