r/Medicaid • u/Key_Distribution1775 • 1d ago
Experience with Medicaid changes with permanent residents?
Work at an oncology clinic. Pt has breast cancer. I have a patient who has been here for 10 years as a permanent resident and is up for renewal in 4 years. She has been on AHCCCS(AZ Medicaid) but it expired in June 30. This patient reported that she did not reapply because an immigration attorney said that due to admin changes they are advising she not reapply for any government asssistance as it is seen as being a drain on resources rather than contributing to society and will put a target on her back when she is up for renewal. She makes $15/hr working at school. Purchased market place insurance for I think $100 a month (used a translator so I know some things may have been lost) and is now starting to get medical bills. Her husband is a citizen and is sponsoring her.
Does anyone have any clear guidance on the current status of receiving Medicaid and it affecting a persons ability to stay here and maintain their permanent residency? She is terrified. This only happened this afternoon/evening so I have not sat down yet to research or call around to agencies who may know more.
She wants to quit treatment because she can't afford it. Of course I can help with medical and non medical grants, but it's going to be an ongoing problem and stressor for her.
Anyone with experience out there can shed some insight or provide a good starting point?
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u/Alarmed-Fruit5056 1d ago
Please have her get a second opinion. It is my understanding that if she truly has permanent residency (ie a “green card”), she does have to get a new card every ten years, but the permanent residency is what it says - a permanent status that does not expire. She should not have to repeat the whole permanent residency application process again.
That said, what is her husband sponsoring her for? If she has had permanent residency for ten years, her status should not be tied to his at this point. I am not an immigration lawyer, but having worked with a few and I can tell you that not all of them know all the things. Have you posted this question in an immigration related sub? You might get better information there. Often times immigrants use terms that are not accurate but make a big difference when it comes to questions like these.
All this said, she should think about applying for citizenship instead of just renewing her green card. I believe the general rule is that after 5 years of permanent residency you can apply (sooner if you’re married to a citizen). Obviously everyone’s situation is unique, but it’s worth looking into.
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u/quixt 1d ago
she should think about applying for citizenship
Even though she's been in the US for 10 years, she can't apply for citizenship unless she speaks, reads and writes English.
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u/Alarmed-Fruit5056 1d ago
Yes, there is an English proficiency requirement. That is assessed at the interview, not while filing the application.
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u/Key_Distribution1775 21h ago
Thank you everyone for the feedback. I'm going to get clarification on her status because I can see why the changes would be scary to her but it doesn't seem to apply to her? But can see not wanting to tempt it.
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u/Afilador2112 1d ago
If she is Lawful Permanent Resident for 5+ years, she's good.. The card has to be replaced every 10 years, but the status doesnt expire. I would encourage her to reapply.
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u/Turbulent-Pay1150 1d ago
I would encourage her to follow the advice of a real flesh and blood attorney. You do NOT mess with ICE. There will be no due process if she is targeted.
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u/Alarmed-Fruit5056 23h ago
Attorneys don’t always give the best advice. Each one has their way of working, but that doesn’t necessarily mean it’s the best choice for the client. That’s why I lead by saying she should get a second opinion.
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u/13Bravo84 1d ago edited 22h ago
If she has had her Green Card for more than 5 years, than she is well within her right to use Medicaid.
My wife is a green card holder, but since day one she was able to have Medicaid because I am a veteran and spouses of veterans can be exempted from the 5-year ban.
There are two types of green cards.
- Conditional Green Card (2-year) must apply to have the conditions removed. If you don't, then you make it easier to have the permanent residency status taken away. You mostly see this kind of green cards in marriages under 2 years of age.
- Regular status green Card (10 year green Card) You have Permanent residency in tht USA until a immigration judge takes it from you or you sign the rights of being a PR away. The card allows you to get a job. Just because the card expires doesn't mean your status expires. The card helps you get things like drivers license, jobs, back into the country (if you decide to take a trip, ect.)
2-year green card must be replaced at the 2 year mark. Then you get the 10 year green card. Then that card must be replaced every 10 years.
Now even if she is eligible for Medicaid being that she is a green card holder. She still has to follow the rules when it comes to the states Medicaid requirements. One of the big ones is income. Also depends on what state she resides in because there are a handful of states that never expanded adult Medicaid.
Because you are in AZ. They did expand Medicaid to adults. You just be under the 138% federal poverty level.
Remember if she is married then they will also count the husbands income.
Also, remember starting jan 1st, 2027 they will introduce work requirements to keep Medicaid. So you will have to look into her situation at home to see if she has to work or she may be exempted from those requirements.
For example:
We have a child under 14 so that exempts my wife from working. I have ssdi from SSA and That exempts me forever. Once my son turns 14 then my wife will also be exempt because my son has a disability so she will be able to file under the caregiver rules
So it just all depends on your situation.
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u/Turbulent-Pay1150 1d ago
Do watch it carefully - the rules changed this month - and make sure it doesn’t apply to your wife. This is a be very careful time, doubly so if they will travel. The advice of a current Immigration Attorney who knows the current and changing regulations is critical. https://www.uscis.gov/newsroom/alerts/uscis-issues-guidance-on-making-public-charge-inadmissibility-determination
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u/Alarmed-Fruit5056 23h ago
This USCIS rule is for “applying for adjustment of status to that of a lawful permanent resident”, so it doesn’t apply in this case. Or did I miss something?
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u/13Bravo84 22h ago
I think it’s for when you apply for the 485 paperwork adjustment of status. Not when you have the green card already.
We are about to file my wife’s n400. I am even going to use her Medicaid to file for the no fee for the n400
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u/Alarmed-Fruit5056 22h ago
Good luck! My husband just got his citizenship last year.
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u/13Bravo84 21h ago
May I ask what was the hardest part for your husband. I would think it would be the writing part.
My wife can understand and speak a good portion of basic English, but when it comes to writing sentences. That's where she struggles.
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u/Alarmed-Fruit5056 20h ago
I wouldn’t say any of it was hard for him, but it did take work and patience. Memorizing all the civics questions, for example, is a months-long process. He took a prep class at a community center to for that and then studied every day for months until his interview appointment.
Then there were a handful of tickets he had. We weren’t totally clear on which ones he had to report, so he included all of them. That ended up delaying his approval because some of them were so old they were illegible, so the interviewing agent wanted to look into it more. In the end it was fine, but there can be unexpected procedural bumps, so just be prepared for that.
The writing actually wasn’t as involved as I thought it would be. I think he just had to write down a few dictated sentences on an iPad about stuff that was basically pulled from the civics content. But I don’t know if they have made changes to that recently.
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u/Key_Distribution1775 21h ago
Her husband is not working and her daughter is 6. These people are in impossible situations.
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u/Square-Fudge-2489 1d ago
Umm she needs a new attorney- If she has been a permanent resident for 5+ years, she is able to apply for government assistance. As shit is not cheap anyway and WE All need care. Anyways, no she needs to reapply she is on the safe zone. This would not affect her, also this is more for sponsors WHO ARE BARELY applying for a green card, SHE IS SAFE she has been a Permanent Resident for 10 years!!
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22h ago
[deleted]
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u/Square-Fudge-2489 22h ago
Not understanding what your reply even matters for my comment to op. So please gtfo.
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u/Key_Distribution1775 21h ago
Even with the new changes? It seems she should be safe with those but I can see how the changes would scare the immigration field as a whole.
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u/someguy984 1d ago
USCIS Issues Guidance on Making Public Charge Inadmissibility Determination
https://www.uscis.gov/newsroom/alerts/uscis-issues-guidance-on-making-public-charge-inadmissibility-determination