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Immigration and Customs Enforcement Won't Chase Illegal Immigrants Going to Exchanges

By Dena Bunis, CQ HealthBeat Managing Editor

October 29, 2013 -- Immigration and Customs Enforcement (ICE) officials will not be knocking at the doors of illegal immigrants who have applied for health coverage in the new health law marketplaces for people in their household who are legal residents or citizens of the United States.

The Department of Homeland Security (DHS) explained that reality in a memorandum it issued this past week.

The memo said that when it comes to information people provide to the federal government for purposes of getting household members signed up for coverage under the health law, "ICE does not use information about such individuals or members of their household that is obtained for purposes of determining eligibility for such coverage as the basis for pursuing a civil immigration enforcement action against such individuals or members of their household, whether that information is provided by a federal agency to the Department of Homeland Security for purposes of verifying immigration status information or whether the information is provided to ICE by another source."

Coverage under the health law (PL 111-148, PL 111-152) is only available to legal permanent residents and U.S. citizens. But a 2010 Census Bureau report noted that about 9 million people lived in so-called mixed status homes, where some people in the household were citizens or legal residents and some were not. The Pew Research Center also estimates that 4.5 million U.S.-born children have parents who are not living here legally.

Those parents who may want to get health insurance for their citizen children through the exchanges will be required to provide information to the new marketplaces about their income and immigration status so the government can determine whether their children—or other legal household members—qualify for Medicaid, the Children's Health Insurance Program or a federal subsidy for a marketplace plan.  At a recent public event for D.C. residents about the district's marketplace, the question came up about whether an illegal immigrant would be exposed if he or she tried to sign up a family member.

The way DHS is treating the requirement that people provide health law implementers with their immigration status is much the same as when census takers went out into the field in 2000 and 2010. Federal officials were keenly interested in learning how many undocumented immigrants were living in the U.S. and immigration officials made it clear that if people put their illegal status on a census form, that would not trigger an ICE investigation.

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