Health Insurance Subsidies for Lawfully Present Immigrants in 2027

What this page is, and is not

I am a licensed health insurance broker. I am not an immigration attorney, and nothing here is immigration or legal advice. Questions about your status belong with an immigration attorney or an accredited representative. What I can do is explain the health insurance rules as published and help you compare plans once you know where you stand.

The 2027 change in brief

The 2025 federal budget reconciliation law, Public Law 119-21, limits the premium tax credit for non-citizens starting with 2027 coverage. According to KFF, only three groups of non-citizens remain eligible for the credit and for cost-sharing reductions:

• Lawful permanent residents (green card holders).
• Cuban and Haitian entrants.
• People living in the U.S. under the Compacts of Free Association with the Marshall Islands, Micronesia and Palau.

U.S. citizens are not affected by this change. The usual income rules still apply to everyone who remains eligible: for 2027, the credit is available between 100 and 400 percent of the federal poverty level, up to $63,840 for one person and $132,000 for a family of four.

Who loses the credit in 2027

Many other lawfully present people can still buy a Marketplace plan but generally can no longer receive a tax credit for it starting January 1, 2027. KFF's 2027 open enrollment overview and its implementation analysis name groups including:

• Refugees and asylees who do not yet have a green card.
• People with temporary protected status (TPS).
• People on work visas and many other visa categories.
• Trafficking victims and other humanitarian categories.

This list is not complete, and individual situations vary. HealthCare.gov's page on coverage for lawfully present immigrants lists the statuses that count as lawfully present. KFF also notes that DACA recipients are not eligible for subsidies under a 2025 federal regulation and the reconciliation law.

The Congressional Budget Office estimates about one million more people will be uninsured by 2035 because of this provision, according to KFF. Full-price coverage will be hard to afford for many families.

The change that already started in 2026

A separate part of the same law took effect January 1, 2026. Before then, a special rule let some lawfully present immigrants with income below the federal poverty level get the tax credit. It applied to people whose immigration status kept them out of their state's public health program, including people in the five-year waiting period many new green card holders face. KFF describes this in its key facts on immigrant coverage.

Starting with 2026 coverage, that rule is gone. People in that situation with income under 100 percent of the poverty level can no longer get the credit. In 2027 the two changes stack. A green card holder under the poverty line in the waiting period gets no credit, and a person in a non-qualifying status gets no credit at any income.

What happens at renewal for 2027

On HealthCare.gov, KFF reports that the Marketplace checks immigration status electronically through the federal SAVE system. For people already enrolled, it plays out roughly like this:

1. Verified as still eligible. You keep your credit for 2027.
2. Not verified. You get a notice and have 95 days to send documents, such as a green card, work permit or I-94. You may keep the credit during that time, but you must pay it back at tax time if you turn out to be ineligible.
3. No update and no verification by the plan selection deadline. The credit ends January 1, 2027.
4. Lawfully present but in a non-qualifying status. You are generally renewed into a plan at full price unless you cancel. If you miss a payment, the shorter grace period for unsubsidized plans applies, not the three-month period for people receiving a credit.

States that run their own exchange, such as Georgia Access in Georgia, follow their own procedures but must verify status too.

Read every letter from the Marketplace in November and December. A missed document request is one of the easiest ways to lose a credit you still qualify for.

Repaying credit you were not eligible for

Starting with the 2026 tax year, federal law no longer caps how much excess advance credit you repay. If you keep receiving the credit in 2027 and later turn out to be ineligible, you could owe all of it back when you file. My guide on paying back the premium tax credit explains how that works. If your status changes, update your application right away rather than waiting.

Documents to keep handy

Whatever your status, keep these ready during open enrollment:

• Your immigration documents, such as a green card, employment authorization document or I-94.
• A Social Security number for each applicant who has one.
• Proof of household income, such as pay stubs or last year's tax return.
• Any Marketplace notices from 2026, including document requests.

If HealthCare.gov asks you to upload documents, do it well before the deadline and keep a copy of what you sent. If you are not sure which document proves your status, ask an immigration attorney or an accredited representative rather than guessing.

Mixed-status families

Many households include people with different statuses. Each person's eligibility is decided separately. A citizen child or a green card holder spouse can keep a credit even if another family member cannot. KFF notes that if the person listed as the primary subscriber is no longer eligible, HealthCare.gov will name another eligible household member as the primary subscriber. The Marketplace only asks about immigration status for people who are applying for coverage.

The math can get complicated in these households, because the credit only helps with eligible members' coverage. Run the numbers before you assume the whole family is better or worse off.

Your options if you lose the credit

If you are lawfully present and lose the credit, you generally have these paths:

• A full-price Marketplace plan. It is still available to you. You cannot be turned down for health reasons, and pre-existing conditions are covered. Full price is the catch: 2027 rates are up about 16 percent on average across my states. See 2027 premium increases by state.
• Coverage through an employer. If your job offers it, the employer plan is not affected by these changes and is often the simplest choice.
• A private, medically underwritten plan, if approved. It is priced on age, ZIP code and health rather than income. You answer health questions, and approval is not certain. If approved, a private plan can start on the first of a month you choose. Private plans set their own residency and documentation requirements, which vary by plan, so I check those before you apply.
• Community health centers. They see patients with or without insurance and charge on a sliding scale.

For a healthy household that just lost its credit, a private plan can sometimes cost less than paying full price on the Marketplace. For anyone with an ongoing health condition, a full-price Marketplace plan is often the safer choice because it cannot decline you.

Timing for 2027

On HealthCare.gov, open enrollment for 2027 runs November 1, 2026 to January 15, 2027. Choose by December 15 for coverage that starts January 1. If you are applying for a private plan, apply early in November so you have time to choose a Marketplace plan if you are not approved.

Becoming lawfully present, for example after arriving in the U.S. with a qualifying status, generally opens a 60-day Marketplace special enrollment period. Ask the Marketplace whether a recent change in your status qualifies.

Florida and the other states I serve

Florida has one of the largest immigrant populations in the country, and the effect differs by community. Cuban and Haitian entrants generally keep the credit. People with TPS generally lose it in 2027. Because the credit is federal, families in Texas and every other state I serve face the same rules. My new to the USA guide covers first-year coverage questions in more detail.

Let me help you compare

Tell me your ZIP code, the ages in your household, each person's status category as well as you know it and a rough income range. I will show you what a full-price Marketplace plan costs and, if it fits, price a private plan, subject to approval. There is no fee for my help. Get a quote or call (786) 218-2384. I work by phone and video. For questions about your immigration status itself, please speak with an immigration attorney.