A newcomer’s guide to accessing medical care in the United States

Immigrants in the United States can and should seek medical care when needed, regardless of their visa or immigration status. Emergency rooms must treat you, and most health providers do not report patients to immigration authorities, but the type of care and coverage available will depend on your status, income, and the state where you live.

If you need emergency care

If you are having a life‑threatening emergency, such as trouble breathing, chest pain, serious injury, or severe bleeding, you should go to the nearest hospital emergency room or call 911. Under the Emergency Medical Treatment and Labor Act (EMTALA), hospital emergency departments that participate in Medicare must provide an appropriate medical screening exam and stabilizing treatment to anyone who comes to the ER, regardless of immigration status or ability to pay.

​Key points about emergency care:

• Hospitals cannot turn you away from the ER because you are undocumented, on a visa, or uninsured.
• EMTALA requires emergency departments to evaluate you and provide stabilizing treatment if you have an emergency medical condition or are in active labor.
• You may receive a bill, but many hospitals offer charity care or financial assistance programs that can help reduce or forgive the cost, especially for low‑income patients.

In many states, low‑income immigrants who would qualify for Medicaid except for their immigration status have historically had their emergency hospital care paid for through “Emergency Medicaid,” which reimburses hospitals for emergency services, including labor and delivery, even if the patient is undocumented or subject to the five‑year bar on Medicaid. However, a new federal data‑sharing agreement now allows Immigration and Customs Enforcement (ICE) to access certain Medicaid data, including information tied to Emergency Medicaid, to help locate people who are not lawfully present in the United States.

In practice, this means that immigrants in many states who use Emergency Medicaid for hospital care now face a new and serious risk that their Medicaid enrollment data could be used in deportation cases, even though hospitals are still legally required to provide emergency treatment.

Because this is a fast‑changing area and states are responding in different ways, it is especially important to talk with an immigration attorney before or after using Emergency Medicaid if you are worried about how this might affect you or members of your family.

Getting non‑emergency and routine care

​For non-urgent health needs, such as annual exams, help managing chronic illnesses like diabetes, care during pregnancy, or mental health counseling, immigrants often use community health clinics or low-cost clinics, or may be eligible for certain health insurance plans. The type of provider you choose can depend on your insurance eligibility, income, the services you need, and where you live. Community health centers and free clinics are important resources because they often accept patients regardless of immigration status or ability to pay, offering sliding-scale fees and language assistance.

​Common options include:

• Community and migrant health centers: Federally qualified health centers (FQHCs) and migrant centers serve all patients, regardless of status, with sliding-scale fees based on income.
• Free and low‑cost clinics: Many cities, including Oklahoma City, have free or income‑based clinics that offer primary care and some specialty services to uninsured patients, including undocumented immigrants.
• Faith‑based and nonprofit clinics: Organizations such as ICNA Relief’s Shifa Clinic in Oklahoma City offer free health screenings and primary care on specific days, with some specialty clinics for neurology, OB/GYN, psychiatry, and endocrinology.
• Hospital outpatient clinics: Some public or nonprofit hospitals operate outpatient clinics with discounted fees or charity programs for low‑income immigrants.
• CAIR Oklahoma health and wellness programs: Partner with medical organizations to offer affordable vaccinations and medical exams, including services often needed for immigration processes.
• University of Oklahoma Center for Travel and Immigrant Health: Provides cross‑cultural care and specialized services for migrants and refugees, emphasizing human rights, dignity, and advocacy.

Students, workers, and other non-immigrant visa holders should also check whether they are eligible for employer‑sponsored plans, student health plans, or private health insurance plans in the individual market.

Overview of health coverage for immigrants

The US health care system is a patchwork of public and private coverage options, and immigration status is one factor that determines eligibility.​

Key categories:

• Undocumented immigrants
  • Not eligible for federally funded coverage such as full Medicaid, Medicare, Children’s Health Insurance Program (CHIP), or to buy coverage through the Affordable Care Act (ACA) marketplaces.​
  • May receive payment for certain emergency services through Medicaid if they meet income and other state eligibility requirements, and can use community health centers, free clinics, and charity care programs. Because of the new CMS–ICE data‑sharing agreement, however, enrollment information for people identified as not lawfully present in many states can now be shared with immigration authorities, which may increase the risk that Emergency Medicaid records are used to locate immigrants for enforcement in those states.
• Lawfully present immigrants without green cards (for example, students, workers, some humanitarian categories)
  • Many lawfully present noncitizens can buy ACA marketplace coverage and may qualify for income-based subsidies.
  • Some must wait five years to qualify for Medicaid or CHIP, though children and pregnant people may be covered sooner in some states. Current court orders require CMS to limit Medicaid data‑sharing with ICE in certain states and to exclude data for U.S. citizens and lawfully present immigrants from those states, but experts have raised concerns about whether those protections can be cleanly implemented in practice.
• Lawful permanent residents (green card holders)
  • Green card holders may qualify for Medicaid, CHIP, or marketplace coverage depending on income, time in the US, and state rules. Some remain subject to the five-year Medicaid bar in certain states.
  • Seniors who meet work and residency requirements may qualify for Medicare.

Some states use their own funds to provide broader health coverage to residents regardless of immigration status, but the rules vary widely and may continue to change through legislation and court decisions. In this environment, checking both state‑level guidance and up‑to‑date legal advice is increasingly important before making decisions about applying for public health coverage.

Privacy, HIPAA, and reporting to immigration

Many immigrants worry that going to the doctor or hospital will expose them or their loved ones to immigration enforcement. In general, health care providers have strong privacy obligations and no duty to report patients to immigration authorities.

Important protections and limits:

• Health care providers have no affirmative legal obligation to ask about or report a patient’s immigration status to federal immigration authorities.
• Federal privacy law, The Health Insurance Portability and Accountability Act (HIPAA), generally prohibits providers from sharing personally identifiable health information without the patient’s consent, except in specific situations required or permitted by law.
• HIPAA does not require providers to collect or document a patient’s immigration status in the medical record, and many do not routinely ask about it.

When could information be shared?

• If immigration status is written in a medical record along with other identifiable health information, it can become protected health information (PHI), which cannot be disclosed to law enforcement, including immigration enforcement, unless an exception applies, such as a court order, warrant, subpoena, or a narrow law enforcement request permitted under HIPAA.
• In most cases, a provider may not voluntarily call immigration authorities simply because they suspect a patient is undocumented; any disclosure must either be authorized by the patient or fit within a specific HIPAA exception.
• There are separate rules for mandated reporting of issues such as child abuse, certain injuries, or some infectious diseases, but those reports generally go to public health or child protection agencies, not to federal immigration enforcement.

Because privacy rules are complex and state laws sometimes add extra protections, talking with an immigration attorney is wise if you are worried about how your medical records might be used in an immigration case.

Mixed‑status families and seeking care

Many families in the United States are “mixed‑status,” for example, a lawful permanent resident parent with undocumented children, US citizen children with undocumented parents, or a visa holder married to someone without lawful status.

Helpful points for mixed‑status households:

• US citizens and eligible lawfully present family members can usually apply for Medicaid, CHIP, or marketplace coverage, even if other household members are undocumented.
• When applying for coverage for eligible family members, applicants generally do not need to provide immigration information for relatives who are not seeking coverage.
• Using health coverage and most health services for eligible family members does not, by itself, make an immigrant a “public charge” under current federal policy, but there are narrow exceptions, and rules can change.

Families may still fear that providing an address, phone number, or other information at a clinic could harm undocumented relatives. In practice, safety‑net providers and community clinics serving immigrant communities often maintain strong privacy practices and do not share patient information with immigration authorities except when legally compelled.

How an immigration law firm can help

Medical issues often intersect with immigration law, especially for people who are applying for visas, seeking humanitarian relief, or living in mixed‑status families.

An experienced firm like Stump and Associates in Oklahoma City can:

• ​Review how your current or planned use of health programs may interact with immigration applications, waivers, or public charge considerations under current rules.
• Help mixed‑status families understand which members are eligible for coverage or public programs and how to complete applications without exposing undocumented relatives.
• Coordinate with your medical providers when health conditions, disability, or trauma are part of an immigration case, such as humanitarian relief, hardship waivers, or protection‑based applications.

Because health and immigration policies continue to evolve at the federal and state levels, immigrants in Oklahoma who have questions about seeking care or protecting their status should consider speaking with a qualified immigration attorney for up‑to‑date, personalized guidance.

This article is for informational purposes only and does not constitute legal advice. For personalized assistance, please consult with an immigration attorney at Stump & Associates.

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