Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 10 - EOHHS General Provisions › Subchapter 00 - General Provisions › Part 3 - Medicaid and Children's Health Insurance Program (CHIP) Non-Financial General Eligibility Requirements › Section 210-RICR-10-00-3.7 - Citizenship and Immigration Status

Current through June 14, 2024
A. The requirements
				  related to citizenship and immigration eligibility factors for Medicaid and
				  CHIP-funded coverage categories are established in Federal law as follows:
1. Citizenship - The Federal Deficit
				  Reduction Act (DRA) of 2005 (42 U.S.C. §§
												1305 and  1396r) requires states to provide
				  Medicaid coverage to otherwise eligible applicants who are citizens and
				  nationals of the United States when appropriate verification of
				  self-attestations is provided.
2.
				  Non-citizens - In accordance with the Personal Responsibility and Work
				  Opportunity Reconciliation Act of 1996 (PRWORA,
				   42 U.S.C. §
												1305) and the Children's Health Insurance
				  Program Reauthorization Act (CHIPRA) of 2009 (42 U.S.C. §
												1396), the following non-citizens are
				  provided with Medicaid or CHIP-funded coverage when all other eligibility
				  requirements are met:
a. Adults. Qualified
				  non-citizens over age nineteen (19) as defined in PRWORA eligible under the
				  Medicaid State Plan -
(1) Prior Entry -
				  Qualified non-citizens who entered the United States before August 1,
				  1996;
(2) Exempt from five (5) year
				  bar - Qualified non-citizens who are exempt from the five (5) year bar on
				  Medicaid coverage under Federal law at §402(b) of PRWORA (8 U.S.C. §
														1612(b)), including
				  non-citizens with the following statuses:
(AA)
				  Refugees. Admitted under §207 of Immigration and Naturalization Act (INA)
				  including Afghan and Iraqi Special Immigrants (SIV's) as permitted under
				  Pub. Law
				  111-118;
(BB) Asylees. Granted Asylum under §208
				  of INA;
(CC) Deportation withheld
				  under §243(h) of INA;
(DD)
				  Amerasian entrants. Pursuant to §584 of the Foreign Operations, Export
				  Financing and Related Programs Appropriations Act of 1988 (as contained in
				  §
															101(e) of
				  Pub. Law
				  100-202and amended by the
				  9th provision under Migration and Refugee Assistance
				  in Title II of the Foreign Operations, Export Financing and Related Programs
				  Appropriations Act, 1988, Pub. Law 100-461as
				  amended);
(EE) Cuban or Haitian
				  entrants. As defined in §501(e) of the Refugee Education Assistance Act of
				  1980;
(FF) U.S. Military. Lawfully
				  residing and honorably discharged veterans (except one discharged for reasons
				  of immigration status), or on active duty in the U.S. Armed forces, and their
				  lawfully residing spouses and unmarried dependent children, and the
				  un-remarried widow or widower of the veteran;
(GG) Battered non-citizens. Certain battered
				  spouses, battered children or parents, or children of a battered person with a
				  petition approved or pending under §§204(a)(1)(A) or (B) or 244(a)(3)
				  of INA;
(HH) American Indians. Born
				  outside the U.S. in Canada and is at least fifty percent (50%) American Indian
				  blood and to whom the provisions of §289 of the INA apply; or is a member
				  of a federally-recognized tribe as defined in §
														4(e)   of the
				  Indian Self- Determination and Education Act;
(II) Victims of trafficking. Certified by the
				  U.S. Department of Human Services (HHS) Office of Refugee Resettlement pursuant
				  to §107(b) of the Victims of Trafficking and Violence Protection Act of
				  2000, as a victim of a severe form of trafficking;
(JJ) Receiving disability assistance. Legally
				  entered the U.S. on or after August 22, 1996 and received disability related
				  benefits for a condition that is a disability or is pending a disability
				  determination in accordance with
				   42 U.S.C. §
															1381.
(KK) SSI recipients. Receiving benefits for
				  the U.S. Supplemental Security Income (SSI) program. Treated as a qualified
				  exempt non-citizen under provisions of
				  Pub. Law
				  105-306, if SSI benefits, and associated Title XIX
				  Medicaid were continued and was lawfully residing in the U.S. and receiving SSI
				  on Augusy 22, 1996.
(3)
				  After the five (5) year bar - Qualified non-citizens who were subject to the
				  five (5) year bar (waiting period) on Medicaid eligibility AFTER the five (5)
				  year period is complete, including:
(AA)
				  Lawful permanent residents (LPRs) Green card holders;
(BB) Parolees. Granted parole for at least
				  one (1) year under §212(d)(5) of the Immigration and Nationality Act
				  (INA), except when paroled for prosecution, deferred inspection, or pending
				  removal proceedings;
(CC)
				  Conditional entrants. Granted conditional entry under §203(a)(7) of
				  immigration law in effect before April 1, 1980.
b. Children and youth. Rhode Island resident
				  children under the age of nineteen (19) are not subject to the five (5) year
				  waiting period/bar. As authorized under the Children's Health Insurance Program
				  Reauthorization Act of 2009 (CHIPRA,
				   42 U.S.C. §
													1396) and as described in
				  8 C.F.R. § 103.12(a)(4) the following
				  non-citizen children and youth are NOT subject to the five (5) year waiting
				  period/bar regardless of their date of entry into the U.S.
(1) Qualified Non-citizens - The full range
				  of qualified non-citizens set forth in subpart (a) above and legal
				  non-immigrants whose admission to the United States is not conditioned on
				  having a permanent residence in a foreign country (such immigrants include
				  citizens of the Compact of Free Association States who are considered permanent
				  nonimmigrants but does not include visitors for business or pleasure or
				  students).
(2) Legally Residing
				  Non-Citizens -
(AA) Temporary resident status.
				  Pursuant to §§210 or 245A of the Immigration and Nationality Act
				  (INA) 8 U.S.C. §§ 11011178;
(BB) Temporary protected status. Pursuant to
				  §244 of the INA (8 C.F.R. §
															244);
(CC) Cuban-Haitian entrants. As defined in
				  §
															202(b) of
				  Pub. Law
				  99-603(8 U.S.C. §
															1152), as
				  amended;
(DD) Family unity.
				  Pursuant to §
															301 of
				  Pub. Law
				  101-649(8 U.S.C. §
															1151), as amended,
				  as well as pursuant to §
															1504 of
				  Pub. Law
				  106-554(8 C.F.R. §
															245a);
(EE) Deferred enforced departure (DED). In
				  accordance with a decision made by the President;
(FF) Deferred action status. As set forth in
				  INA Service Operations Instructions at OI §242.1(a)(22);
(GG) Adjusted status. The spouse or child of
				  a United States citizen whose visa petition has been approved and who have a
				  pending application for adjustment of status.
(3) INA Non-citizens - The following
				  categories of non-immigrant children under §101(a)(15) of the Immigration
				  and Nationality Act (INA) (8 U.S.C. §
														1101) are also eligible for
				  coverage under Title XXI:
(AA) Immediate
				  family. Parents or children of individuals with special immigration status
				  under §101(a)(27) of the INA as permitted under §101(a)(15)(N) of the
				  INA (8 U.S.C. §
															1101);
(BB) Fiance(e) of a citizen as permitted
				  under §101(a)(15)(K) of the INA (8 U.S.C. §
															1101);
(CC) Religious workers under
				  §101(a)(15)(R) (8 U.S.C. §
															1101);
(DD) U.S. Attorney General's discretion. The
				  Attorney General of the United States has determined the non-citizen is in
				  possession of critical reliable information concerning a criminal or terrorist
				  organization, enterprise or operation as permitted under §101(a)(15)(S) of
				  the INA (8 U.S.C. §
															1101);
(EE) Victims of trafficking. As permitted
				  under §101(a)(15)(T) of the INA (8 U.S.C. §
															1101);
(FF) U.S. Department of Justice. When
				  assisting in a criminal investigation as permitted under §101(a)(15)(U) of
				  the INA (8 U.S.C. §
															1101);
(GG) Battered non-citizens;
(HH) Petition pending. A petition pending for
				  three (3) years or more as permitted under §101(a)(15)(V) of the INA
				  (8 U.S.C. §
															1101).
c. Pregnant women. All pregnant women who
				  otherwise meet the requirements for Medicaid are eligible without regard to
				  immigration status.
3.
				  Non-qualified non-citizens - In accordance with the provisions of PRWORA,
				  non-citizens who are not pregnant and do not have current documentation of a
				  qualified non-citizen status are not eligible for Medicaid or CHIP coverage
				  except in instances of a medical emergency. Rhode Island resident children
				  under the age of nineteen (19) are not subject to eligibility requirements
				  related to citizenship and immigration status. The provisions governing
				  Medicaid coverage for non-citizens who are RI residents in emergency
				  circumstances are set forth in Part
				  40-05-1 of this Title.
4. Alternative forms of coverage - Lawfully
				  present qualified non-citizens who are ineligible for Medicaid/CHIP funded
				  coverage, may qualify for commercial health insurance coverage through the
				  State's health insurance marketplace known as HealthSource RI (HSRI). To
				  facilitate access to affordable health coverage, any non-citizen who applies
				  for Medicaid and is denied on the basis of immigration status is automatically
				  evaluated for an HSRI plan and is informed if such coverage options are
				  available in the eligibility determination notice.