Which immigrants can get ACA marketplace subsidies in 2027?
Starting with 2027 coverage, only three groups of immigrants can get premium tax credits and cost-sharing reductions: green card holders (lawful permanent residents), Cuban and Haitian entrants, and people living in the U.S. under the Compacts of Free Association (from Micronesia, the Marshall Islands, or Palau). Other lawfully present immigrants, including refugees, asylees, people with Temporary Protected Status, and people on work or student visas, can still buy a marketplace plan but have to pay the full price. Green card holders do not face a five-year wait for marketplace subsidies; that wait applies to Medicaid.
The change comes from the 2025 federal budget law and applies to marketplace coverage starting January 1, 2027.
- Still eligible: green card holders, Cuban and Haitian entrants, and Compact of Free Association migrants, as long as they meet the usual income and other rules.
- No longer eligible: refugees, asylees, people with Temporary Protected Status, people on work, student, or other temporary visas, and other lawfully present immigrants without a green card. You can still enroll during open enrollment, but at full price.
- Very low income: since 2026, lawfully present immigrants earning under 100% of the federal poverty level who can't get Medicaid because of their immigration status can't get subsidies either.
- Medicaid and Medicare: similar limits apply. Since October 1, 2026, federal Medicaid is generally limited to green card holders (usually after a five-year wait), Cuban and Haitian entrants, and COFA migrants, though some states cover more people with their own money. Medicare eligibility is limited to citizens and the same groups.
Bringing parents over on a tourist visa? Our survey of immigrant families covers the travel insurance and other options people use.
Not sure where you stand? The marketplace application checks your immigration documents and tells you what you qualify for, and free local help from HealthCare.gov can walk you through it.