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Yes—many lawfully present immigrants can buy a Health Insurance Marketplace plan without a premium tax credit, but undocumented immigrants and DACA recipients cannot enroll in a Marketplace plan. For 2027 coverage, the federal subsidy rules narrow: among noncitizens, only lawful permanent residents, Cuban or Haitian entrants, and COFA migrants may qualify for premium tax credits and income-based cost-sharing reductions, and they must meet the usual income and other eligibility rules.
The distinction is important: being eligible to buy coverage is not the same as being eligible for financial help. The rules also changed on two different dates: a below-poverty subsidy exception ended for 2026 coverage, while the new three-status limit on subsidies starts with 2027 coverage.
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What changes in 2027: buying coverage versus getting savings
Marketplace enrollment and Marketplace financial help are separate tests. For enrollment, the key immigration threshold is generally being lawfully present in the United States and otherwise eligible. For 2027 premium tax credits and cost-sharing reductions, noncitizens must also meet the narrower “eligible noncitizen” test created by federal law.
CMS says lawfully present noncitizens who are not eligible noncitizens “will remain eligible to enroll in a qualified health plan (QHP) through the Marketplace, if otherwise eligible,” but will have to pay full price starting in plan year 2027. CMS also says the requirement to be lawfully present to enroll has not changed. Read the full CMS guidance on 2027 noncitizen eligibility.
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For noncitizens, the three statuses that can qualify for 2027 subsidies are:
- Lawful permanent residents (LPRs), including green card holders;
- Cuban or Haitian entrants; and
- COFA migrants—citizens of the Marshall Islands, Micronesia, or Palau living in a U.S. state or territory under a Compact of Free Association.
These statuses do not guarantee a credit. A person must also meet the income and other tax-credit requirements. The law does not make every lawfully present immigrant ineligible for coverage; it restricts which noncitizens can receive federal Marketplace savings.
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Which immigrants can buy a plan, and which can get help paying?
Many people with lawful immigration statuses can still apply for a Marketplace plan in 2027, even if they cannot get subsidies. HealthCare.gov’s guidance for lawfully present immigrants says they can get Marketplace coverage if otherwise eligible; its separate immigration-status page warns that some statuses may qualify for coverage but not savings.
| Status | May buy a Marketplace plan if otherwise eligible? | May qualify for 2027 premium tax credit and income-based CSR? |
|---|---|---|
| U.S. citizen or U.S. national | Yes | Yes, if income and other rules are met |
| Lawful permanent resident (green card holder) | Yes | Yes, if income and other rules are met |
| Cuban or Haitian entrant | Yes | Yes, if income and other rules are met |
| COFA migrant | Yes | Yes, if income and other rules are met |
| Refugee or asylee without a green card | Yes | No; full premium |
| Person paroled into the United States, unless also in an eligible group | Yes | No; full premium |
| TPS, DED, or non-DACA deferred action | Yes, for statuses on the coverage list | No based on that status alone; full premium |
| Valid work, student, or other nonimmigrant visa; or an EAD alone | Yes | No based on that status alone; full premium |
| Applicant for adjustment, trafficking status, or certain child asylum or withholding categories | May qualify; check the specific category | Not on the three-status list unless already an eligible noncitizen |
| DACA recipient | No | No |
| Undocumented immigrant | No | No |
HealthCare.gov’s broader list of statuses that may support Marketplace coverage includes refugees, asylees, people with Temporary Protected Status (TPS), people paroled into the country, people with valid nonimmigrant visas such as H-1B or student visas, people with employment authorization documents, trafficking victims, certain Special Immigrant Visa holders, and other groups. Some people with pending applications—such as certain applicants for adjustment of status or trafficking status, and children under 14 with specified pending asylum or withholding applications—may also qualify. That is a coverage list, not a list of who retains 2027 savings.
Do not treat “deferred action” as synonymous with DACA. HealthCare.gov says DACA recipients are not eligible for Marketplace coverage, while other deferred-action statuses appear among statuses that may qualify for coverage. Check the specific immigration category rather than relying on a general label. HealthCare.gov’s overview of health coverage for immigrants also explains that undocumented immigrants cannot get Marketplace coverage, though they may apply on behalf of documented individuals.
Why are there two different effective dates?
Two provisions changed assistance at different times. The 2026 change concerned certain immigrants below the poverty line who could not get Medicaid because of their immigration status. The 2027 change limits which noncitizens can receive Marketplace subsidies, regardless of whether they are above or below that poverty threshold.
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January 1, 2026: below-poverty subsidies ended for a specific group
Starting January 1, 2026, lawfully present immigrants with household income below 100% of the federal poverty level who are barred from Medicaid because of immigration status—including people in the five-year Medicaid waiting period—no longer qualify for the prior Marketplace subsidy exception. This did not itself take away their ability to buy an unsubsidized Marketplace plan if otherwise eligible.
KFF reports that the Congressional Budget Office estimated this separate provision would result in 200,000 additional people uninsured and $27.3 billion less federal spending over 2026–2035. Those are CBO estimates as reported by KFF’s implementation analysis, not a count of current enrollment.
January 1, 2027: subsidies limited to eligible noncitizens
Section 71301 of Public Law 119-21 changes the Marketplace premium-tax-credit rule for taxable years beginning after December 31, 2026. In Marketplace operations, this means plan year 2027. For noncitizens, the new “eligible alien” requirement is met by the three groups listed above; the statute does not eliminate the separate right of other lawfully present people to enroll at full price if they are otherwise eligible.
KFF reports the CBO estimate for this broader 2027 subsidy restriction as $91.4 billion less federal spending and an additional 1 million people uninsured by 2035, with most coverage losses occurring in 2027. These figures are KFF’s report of the CBO estimate; they are not an independently checked enrollment forecast.
What income and other rules apply to a 2027 tax credit?
Immigration status is only one part of the test. For 2027, KFF describes the general premium-tax-credit income range as 100% to 400% of the federal poverty level: $15,960 to $63,840 for one person, or $33,000 to $132,000 for a family of four. These are KFF’s 2026 figures for the 2027 plan year, not a newly quoted HHS poverty-guideline notice. Income in that range is not enough for a noncitizen who is outside the three eligible groups.
Other rules apply to citizens and noncitizens alike. According to KFF’s Marketplace FAQ, a person generally cannot receive a premium tax credit for months they are eligible for Medicaid, CHIP, Medicare, or military coverage, or have access to qualifying employer coverage. For 2027, an employee’s share of an employer premium above 10.22% of household income may make that employer coverage unaffordable for the tax-credit test; an employer plan that fails minimum value may also be an exception.
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People below 100% of poverty generally do not qualify for a premium tax credit. Since the 2026 exception ended, being unable to get Medicaid because of immigration status does not restore that Marketplace subsidy for a person below the poverty line. An LPR in the five-year Medicaid waiting period can still meet the 2027 immigration-status test for a credit, but must satisfy the income and other requirements too.
What happens if I already have a Marketplace plan?
On the federal Marketplace platform, a current enrollee who remains lawfully present but loses subsidy eligibility may be automatically re-enrolled into a 2027 plan without APTC or cost-sharing reductions unless they cancel. That can leave a person with a full-price premium bill even if they took no action to renew.
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CMS advises current noncitizen enrollees to return during 2027 Open Enrollment and update their application with their most recent immigration status. The federal Marketplace may use information already in, or newly checked against, the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) system. If SAVE confirms an eligible-noncitizen status, subsidies may continue if all other rules are met. If eligible status cannot be verified, the Marketplace may end APTC and cost-sharing reductions while allowing enrollment to continue if lawful presence is established. If SAVE indicates the person is no longer lawfully present, Marketplace eligibility may end.
CMS’s guidance says that if an enrollee does not cancel and is determined to remain lawfully present, they may be automatically re-enrolled without APTC or CSRs. If you do not want a full-price plan, do not rely on missing a payment as a substitute for cancellation. Use the federal Marketplace’s instructions to cancel a Marketplace plan, and confirm how cancellation works with your exchange if you use a state-based Marketplace.
Unpaid premiums can lead to termination under the insurer’s or state’s nonpayment rules, and medical bills during a period when coverage is not in force may become your responsibility. After losing coverage for nonpayment, you may have to wait until the next Open Enrollment unless you qualify for a Special Enrollment Period.
What should I do if SAVE cannot verify my status?
If a federal Marketplace applicant attests that they are an eligible noncitizen but SAVE cannot confirm it, the Marketplace may issue a data-matching issue and give them 95 calendar days to submit documents. During that period, a person may enroll and receive APTC and CSRs if otherwise eligible, but those credits may have to be repaid on a later tax return if they are ultimately found ineligible for subsidies.
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CMS lists documents such as a Permanent Resident Card (green card), Employment Authorization Document, or Arrival/Departure Record (I-94 or I-94A) as examples of proof. An applicant can have both a lawful-presence issue and an eligible-noncitizen issue. Proof of lawful presence without proof of one of the eligible subsidy statuses can allow the person to keep a plan while losing financial help; failure to prove lawful presence can lead to Marketplace enrollment being denied.
KFF cautions that SAVE is a point-in-time check and may not reflect a later change in status, such as becoming a lawful permanent resident. If the status shown in the application is out of date, submit current documentation promptly and respond to Marketplace notices by their deadlines. CMS says notices explain eligibility determinations and appeal rights. For federal Marketplace questions, the call center is 1-800-318-2596 (TTY: 1-855-889-4325).
When does 2027 Open Enrollment end?
For HealthCare.gov, Open Enrollment for 2027 coverage began November 1, 2026. Enroll or change plans by December 15 for coverage beginning January 1, provided you pay the first premium. The final federal deadline is January 15, 2027; a plan selected from December 16 through January 15 can start February 1 after the first premium is paid. After January 15, you generally need a Special Enrollment Period to enroll or change plans. Check the federal Marketplace deadlines for current details.
KFF reports that 29 states use the federal Marketplace platform and 22 states, including the District of Columbia, operate their own exchanges. State-based exchanges must apply the federal subsidy restriction, but their notices, deadlines, and redetermination processes can differ. Follow your state exchange’s instructions rather than assuming that every HealthCare.gov operational detail applies to it.
How should I compare full-price Marketplace coverage with other options?
If you cannot receive a tax credit, compare actual plan benefits and the full premium rather than assuming that a lower advertised price offers equivalent protection. There is no single national full-price 2027 premium in the available federal guidance; premiums vary, and KFF notes that unsubsidized coverage may be unaffordable for many people. Get a current quote for the specific location, household, and plan before deciding.
- Marketplace plan at full price: Marketplace plans meet ACA standards. If you are eligible to enroll, compare premiums, deductibles, provider networks, and covered services on the exchange.
- Off-Marketplace ACA plan: KFF says insurers may sell plans outside the Marketplace with the same essential health benefits and protections for pre-existing conditions. Premium tax credits and cost-sharing subsidies are not available for off-Marketplace coverage, so check whether a Marketplace option is more affordable before buying elsewhere.
- Non-ACA products: Short-term limited-duration and hospital indemnity plans may appear cheaper but can exclude pre-existing conditions, omit essential benefits such as maternity care or prescription drugs, or impose annual or lifetime dollar limits. Warning signs include a statement that the product is not comprehensive coverage or health-history questions on the application.
- Medicaid, CHIP, and local care: Apply if your status, income, and state rules may qualify you. Some lawfully residing pregnant people and children can qualify under state options, and some LPRs have no five-year wait because of a prior status such as refugee or asylee. HealthCare.gov also points people who cannot get Marketplace coverage to community health centers, which may offer primary care on a sliding fee scale.
Some states use state funds for coverage or subsidies beyond the federal rules, but programs can change or have enrollment caps. KFF identifies New Mexico as a state using funds for premium subsidies through its exchange for lawfully present noncitizens losing federal subsidies and for DACA recipients; this is not a complete state-by-state list. Free in-person Marketplace help is available through navigators and other assisters; find help through your state Marketplace.
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How do taxes work if I have a 2027 Marketplace plan?
CMS says every lawfully present Marketplace enrollee, including people without eligible-noncitizen subsidy status, will receive Form 1095-A beginning in January 2028 for the 2027 tax year. A person who received advance premium tax credits uses the form’s monthly enrollment premium, APTC, and second-lowest-cost Silver plan information to complete IRS Form 8962.
A lawfully present enrollee who was ineligible for APTC because of immigration status will also receive Form 1095-A, but some Part III premium and credit fields may be blank or show zero. In a mixed-status household, the monthly enrollment premium and second-lowest-cost Silver premium may be reduced to exclude the share allocated to lawfully present people who are not eligible noncitizens. Contact the Marketplace Call Center about errors on the form.
KFF also reports that, beginning with the 2028 tax year, exchanges are expected to verify eligibility—including income, other coverage, residence, family size, and immigration status—before eligible people receive premium tax credits. Until verification is complete, they may need to pay the full premium. This is a later administrative change, separate from the 2027 immigration-status rule.
Does the Marketplace rule change Medicaid or public charge?
No: the 2027 Marketplace subsidy restriction is not the same as the separate Medicaid and CHIP funding provision. Section 71301 concerns Marketplace APTC and CSRs; section 71109 concerns federal financial participation for Medicaid and CHIP coverage of certain noncitizens. HealthCare.gov says full Medicaid or CHIP is generally limited to certain qualified noncitizens, including LPRs, Cuban or Haitian entrants, and COFA migrants, with state options for some lawfully residing pregnant people and children. A person in a five-year Medicaid wait may still be able to buy a Marketplace plan, subject to the separate Marketplace eligibility and subsidy rules.
HealthCare.gov directs people applying for a visa, entry, or lawful permanent residence to review current Department of Homeland Security public-charge guidance before applying for Marketplace, Medicaid, or CHIP coverage. The available guidance cited here does not establish whether a full-price Marketplace plan or a plan receiving a tax credit is counted, so do not assume a yes-or-no answer from the Marketplace eligibility rules alone.
What to do next
- Identify the exact immigration category. Determine whether it qualifies for Marketplace enrollment, 2027 subsidies, both, or neither; do not infer eligibility from a general description such as “deferred action.”
- Check the other tax-credit rules. Review income, household details, and eligibility for Medicaid, CHIP, Medicare, military coverage, or employer insurance.
- Update your application and read every notice. Use the federal or state exchange where you enrolled, supply current status information, and meet verification deadlines.
- Review the full premium before renewing. If you will not keep a plan without subsidies, cancel through the exchange rather than letting an unpaid bill determine what happens.
- Compare realistic alternatives. Check Medicaid or CHIP where applicable, ask about state assistance, and use a navigator or community health center if you need help understanding options.
Frequently Asked Questions
Can I apply for Marketplace coverage for a family member if I am undocumented?
Yes. HealthCare.gov says an undocumented person may apply on behalf of documented individuals. The undocumented applicant cannot enroll in a Marketplace plan themselves; each family member’s eligibility is assessed individually.
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The cited HealthCare.gov material directs people applying for a visa, entry, or permanent residence to review current Department of Homeland Security public-charge guidance. It does not specify whether a full-price plan or a subsidized plan is counted, so check the current federal guidance or consult a qualified immigration adviser for your circumstances.
Can a TPS holder get a Marketplace plan in 2027?
TPS appears among statuses that may qualify for Marketplace coverage, but TPS by itself is not one of the three noncitizen statuses eligible for 2027 Marketplace savings. A TPS holder who is otherwise eligible can generally enroll at full price.
Will a green card holder automatically get a premium tax credit?
No. A green card satisfies the immigration-status category for the 2027 tax-credit test, but income and other rules still apply. Eligibility for Medicaid, Medicare, military coverage, or qualifying employer insurance can affect whether a person receives a credit.
