Jordan Ellis
In the United States, undocumented immigrants have limited access to healthcare. They are largely ineligible for federal healthcare programs and are unable to access the Federal Health Insurance Marketplace. However, under the Emergency Medical Treatment and Labor Act (EMTALA), all patients, regardless of citizenship or immigration status, have access to emergency medical treatment. This has raised concerns among immigrant families, who fear that seeking medical help could put them and their family members at risk of facing immigration enforcement. In New York City, every resident has the right to quality healthcare and city services, regardless of immigration status, ability to pay, or language spoken. NYC Health+Hospitals locations do not require information on immigration status and offer services in multiple languages. Furthermore, healthcare providers have no legal obligation to report a patient's immigration status to federal authorities.
| Characteristics | Values |
|---|---|
| Health care benefits for illegal immigrants in NY | Emergency care, access to treatment in hospital emergency rooms, and access to healthcare and nutrition programs under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) |
| Health care benefits for illegal immigrants in the US | Emergency Medicaid, limited primary care and prescription drugs through 1,400 Federally Qualified Health Centers (FQHCs), insurance through their employers, and private health coverage |
| Legal obligation of hospitals to report illegal immigrants | No affirmative legal obligation to report to federal immigration authorities about a patient’s immigration status |
| Language support for illegal immigrants in NY hospitals | Right to get care and written materials in their preferred language, qualified interpreter in any hospital or healthcare setting, and translations of any written materials from the healthcare provider or insurer |
| Other services for illegal immigrants in NY | Low- and no-cost city services, food, education, legal services, and public safety, free identification card for all NYC residents aged 10 and older |
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What You'll Learn
- Hospitals are not legally required to report patients' immigration status
- Immigrants have the right to receive healthcare services in their preferred language
- Undocumented immigrants have access to emergency care
- Undocumented immigrants are ineligible for federal healthcare programs
- Hospitals must prepare for potential immigration enforcement
Hospitals are not legally required to report patients' immigration status
In the United States, undocumented immigrants are largely ineligible for federal healthcare programs like Medicaid and Medicare and are barred from accessing most federal health care benefits, except emergency care. The Personal Responsibility and Work Opportunity Act of 1996 (PRWORA) prohibits undocumented immigrants from accessing federal healthcare benefits. However, under the law, undocumented immigrants may access emergency Medicaid, treatment in hospital emergency rooms, and healthcare and nutrition programs under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
The Emergency Medical Treatment and Labor Act (EMTALA) ensures that all patients, regardless of citizenship or immigration status, have access to emergency medical treatment. EMTALA ensures that Medicare-participating hospitals do not turn away individuals who need life-saving care. Undocumented immigrants' use of EMTALA-related services is often covered via emergency Medicaid.
In New York City, every resident has the right to quality healthcare and city services, regardless of their immigration status, ability to pay, employment status, or ability to speak English. NYC Health+Hospitals locations and NYC Health Department public health clinics provide services in multiple languages. Residents do not need to share any information about their immigration status to receive care. NYC also offers a range of services, including food, education, legal services, and public safety.
To address concerns among immigrant families about immigration enforcement, hospitals, medical centers, community health centers, and other healthcare facilities can provide advice on how to prepare for and respond to enforcement actions by immigration officials and interactions with law enforcement that could affect their patients. Additionally, healthcare providers should avoid collecting immigration status information unless necessary for a specific purpose, such as Medicaid enrollment. When collecting such information, it should be kept separate from the patient's medical and billing records.
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Immigrants have the right to receive healthcare services in their preferred language
In the United States, undocumented immigrants are largely ineligible for federal healthcare programs like Medicaid and Medicare and are unable to access most federal health care benefits, except for emergency care. However, immigrants have the right to receive healthcare services regardless of their immigration status or ability to pay. They are entitled to basic emergency room treatment for serious medical emergencies, including labor and delivery, and healthcare services from community health centres, migrant health centres, and free clinics.
Despite having the right to receive healthcare, immigrants may face challenges in accessing care due to language barriers. Language access challenges are a common issue, with many non-English speakers facing difficulties in understanding and communicating their health needs. This is a significant barrier to healthcare access, as evidenced by surveys showing that a quarter of immigrants with limited English proficiency (LEP) have had difficulty obtaining health care services due to language barriers. Furthermore, among those who skipped or postponed healthcare, 25% cited not being able to communicate in their preferred language or obtain an interpreter as a reason.
To address these challenges, immigrants have the right to receive language assistance services at no cost when seeking healthcare at hospitals or community health centres. These language assistance services can include bilingual staff, telephone interpretation services, or qualified in-person interpreters. It is important to note that children should not be expected to interpret for their family members, especially in healthcare settings.
In addition to language access rights, immigrants in New York have access to certain state-specific healthcare benefits. New York is one of the eight states that offer limited health coverage for uninsured children regardless of their immigration status. Furthermore, New York is among the 24 states that provide comprehensive state-funded coverage to pregnant individuals through the Children's Health Insurance Program (CHIP) From-Conception-to-End-of-Pregnancy (FCEP) option, which offers prenatal care and pregnancy-related benefits.
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Undocumented immigrants have access to emergency care
Undocumented immigrants have very limited access to healthcare coverage in the United States. They are largely ineligible for federal healthcare programs like Medicaid and Medicare and are barred from most federal health benefits. However, they do have access to emergency care under the Emergency Medical Treatment and Labor Act (EMTALA) and emergency Medicaid. EMTALA ensures that all patients, regardless of citizenship or immigration status, have access to emergency medical treatment in hospitals that accept Medicare. This means that undocumented immigrants can receive emergency services in hospital emergency rooms, which are often covered by emergency Medicaid.
In certain states, undocumented immigrants may be eligible for additional state-specific benefits. For example, New York is one of eight states that offer limited health coverage for uninsured children regardless of their immigration status. Additionally, eighteen states, including New York, guarantee prenatal care to all persons regardless of immigration status. Undocumented immigrants can also access limited primary care and prescription drugs through Federally Qualified Health Centers (FQHCs) and may be able to purchase private health insurance or obtain insurance through their employers.
The Personal Responsibility and Work Opportunity Act of 1996 (PRWORA) bars undocumented immigrants from accessing most federal benefits, including federal healthcare programs. However, they may still access federal benefits deemed necessary to protect life or guarantee safety, such as emergency Medicaid and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). To be eligible for these emergency services, undocumented immigrants must meet all of Medicaid's non-financial and financial eligibility requirements.
Undocumented immigrants contribute to federal, state, and local taxes but only receive a small fraction of total health expenditures. They represent the largest group of uninsured individuals in the country, with an estimated 45-71% lacking health coverage. While they have limited access to the US healthcare system, their emergency and lifesaving services are often covered through emergency Medicaid, EMTALA, and state-specific programs.
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Undocumented immigrants are ineligible for federal healthcare programs
Undocumented immigrants are largely ineligible for federal healthcare programs. They are unable to access federal health coverage or the Federal Health Insurance Marketplace under the Affordable Care Act. This means that undocumented immigrants cannot enroll in federally-funded coverage programs such as Medicaid, CHIP, or Medicare, or purchase coverage through the ACA Marketplaces.
However, there are some exceptions to this. Undocumented immigrants may access federal benefits that are deemed necessary to protect life or guarantee safety, such as emergency Medicaid, hospital emergency rooms, and healthcare and nutrition programs under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). To be eligible for these emergency services, undocumented immigrants must meet all of Medicaid's non-financial and financial requirements. The Emergency Medical Treatment and Labor Act (EMTALA) ensures that Medicare-participating hospitals provide emergency medical treatment to all patients, regardless of citizenship or immigration status. Undocumented immigrants' use of EMTALA-related services is often covered by emergency Medicaid.
Undocumented immigrants are a significant contributor to the viability of public health programs like Medicare and Medicaid. They contribute far more in federal, state, and local taxes than they consume in health expenditures. In 2018, they contributed $20.1 billion in federal taxes and $11.8 billion in state and local taxes. Between 2000 and 2011, undocumented immigrants generated a $35.1 billion surplus in the Medicare Trust Fund.
In certain states, undocumented immigrants are eligible for state-specific benefits. For example, eight states offer limited health coverage for uninsured children regardless of status, and eighteen states guarantee prenatal care to all persons regardless of immigration status. Undocumented immigrants can also purchase private health coverage or, in some cases, access insurance through their employers. They can also access limited primary care and prescription drugs through Federally Qualified Health Centers (FQHCs) across the country.
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Hospitals must prepare for potential immigration enforcement
In January 2025, the Trump administration rescinded previous protections against Immigration and Customs Enforcement (ICE) actions at "sensitive locations", including hospitals, schools, and places of worship. This has raised concerns among immigrant families, who may now be hesitant to seek medical care. While ICE officials are now permitted to conduct enforcement at hospitals, they are not explicitly directed to do so, and the frequency of such actions is unknown.
Healthcare providers have no legal obligation to report a patient's immigration status to federal authorities. However, two states currently require hospitals to ask patients about their immigration status and report the amount of uncompensated care provided to undocumented patients. If hospitals must collect this information, it should be kept separate from the patient's medical and billing records.
Hospitals should also educate patients on their rights, providing posters and materials advising them that they have the right to refuse to answer questions from immigration agents and to request a lawyer. Patients should also be informed that they are not required to respond when asked about their immigration status.
To prepare for potential immigration enforcement, hospitals can conduct drills and role-playing exercises to simulate an ICE raid and help staff respond confidently in a stressful situation. Hospitals should also review their policies on responding to law enforcement and ensure these policies address the potential for immigration enforcement.
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Frequently asked questions
No, health care providers have no legal obligation to report a patient's immigration status to federal immigration authorities. The Health Insurance Portability and Accountability Act (HIPAA) privacy law prohibits the use or disclosure of personal health information without a patient's consent, except when required by law.
Yes, every New Yorker, regardless of their immigration status, has the right to quality health care. This includes emergency care at any hospital in NYC. Undocumented immigrants may only access federal benefits that are deemed necessary to protect life or guarantee safety, such as emergency Medicaid.
Undocumented immigrants are ineligible for federal health coverage or access to the Federal Health Insurance Marketplace. However, they can purchase private health coverage or, in some cases, access insurance through their employers.
