In order to qualify for the full range of benefits offered under Medicaid, individuals must be citizens or nationals of the United States or qualified aliens. U.S. nationals are individuals born in certain U.S. territorial possessions. The term qualified alien was created by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193) and includes legal permanent residents, refugees, and asylees.
Legal permanent residents entering after August 22, 1996, are generally barred from receiving full Medicaid benefits for five years, after which coverage becomes a state option. However, children and pregnant women who are lawfully present may be covered during the five-year bar at state option. As of January 2017, 31 states had adopted the option for children, and 23 had adopted it for pregnant women (Brooks et al. 2017).
Non-qualified aliens (as well as qualified aliens subject to a five-year bar on full benefits) who meet income and all other eligibility criteria for the program can only receive limited emergency Medicaid coverage. Examples of non-qualified aliens include those who are unauthorized or illegally present, as well as students and other nonimmigrants who are admitted for a temporary purpose.
TABLE 1. Eligibility for Non-Citizens
|Eligibility group||Federal statutory and regulatory requirements||State plan options|