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January 29, 2019

A Harsh, Little Known Rule Leaves Many Immigrants Without Health Coverage

A legal immigrant who has lawfully resided in the United States for more than five years can become eligible for Medicaid in 44 states if they meet all other eligibility requirements. But it’s not so straight forward in Virginia. That’s because Virginia, along with five other states, has an additional obstacle to qualifying for Medicaid coverage.  This results in a delay – or even a permanent denial – of Medicaid coverage for many Virginia residents.


In the commonwealth, lawfully present immigrants must establish a 40-quarter (10 year) work history, concurrent with the federal five year requirement, before qualifying for Medicaid. Though work quarters of spouses and parents can be included in the calculation, single immigrant adults without parents in the United States would have to wait ten years or more for health coverage. Older legal immigrants who arrive in the United States later in life may never be able to satisfy this requirement. (Pregnant women, children, and a few other categories of immigrants such as refugees, asylees, and veteran families are exempt from having to meet these onerous standards.)

If Virginia lawmakers act to remove this obstacle, the federal government would provide the majority of funding for Virginia to ensure access to health care for legal immigrants. Currently, 1 in 3 non-citizens in Virginia who have lived in the country for more than five years does not have health insurance.

It is time for Virginia to end the 40-quarters rule for Lawful Permanent Residents and ensure their access to health care on the same basis of other Virginians. By imposing additional requirements on people who chose to work, live, and build their lives in the state, Virginia is putting up additional barriers to the health and well-being of its residents. Striking down this obstacle to Medicaid coverage would be a step toward building a better commonwealth for all.

Health Care, Immigration

Freddy Mejia

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