What the 2027 ACA Eligibility Changes Mean for Immigrants (and What to Do Now)
Starting January 1, 2027, the rules for who qualifies for financial help with a Marketplace health plan are changing under the Working Families Tax Cut legislation (Section 71301).
If you or someone in your family is not a U.S. citizen, this is worth reading before open enrollment closes.
Who keeps the subsidy
Only a specific group of non-citizens will remain eligible for the premium tax credit and cost-sharing reductions after January 1, 2027:
Lawful permanent residents (green card holders)
Cuban or Haitian entrants
Individuals lawfully residing under a Compact of Free Association (COFA migrants)
Who loses it
Every other lawfully present non-citizen, including people with TPS, pending or approved asylum, humanitarian parole, and other visa categories, can still enroll in a Marketplace plan.
They just won't get help paying for it.
That means paying full price instead of a subsidized rate.
Medicaid follows a similar path but on a different timeline. Starting October 1, 2026, only lawful permanent residents, Cuban or Haitian entrants, and COFA migrants stay eligible for Medicaid.
Other lawfully present immigrants lose that coverage.
What this means for you
If your coverage depends on a subsidy and you don't fall into one of the protected categories above, your monthly premium could jump significantly once 2027 starts.
The time to plan for that is now, not in January.
A few things worth doing before the change hits: check your current immigration status against the list above, ask what your premium would look like at full price, and look at whether a non-ACA plan makes more financial sense for your situation.
I walk families through exactly this kind of decision every week, and there's no cost to have that conversation.
If you want to know where you stand, reach out and we'll go through your options together.
