Table 1

Citizenship Status and Coverage in Massachusetts prior to ACA Implementation and across the United States after Implementation

Coverage Based on Citizenship StatusMA: Ch. 58 (Pre-ACA)MA: Post–ACA ImplementationACA in Most States
Undocumented Yes: HSN if income eligible,
exchange 
Yes: HSN if income eligible
No: exchange 
No expansion 
Undocumented deferred action recipients (DACA/Dreamers) Yes: HSN if income eligible,
exchange 
Yes: HSN if income eligible
No: exchange 
Yes: Medicaid expansion if income eligible and under age 18
No: if over age 18 
Temporary protected/special status: refugees, asylees Yes: HSN, exchange, MassHealth, CommCare if income eligible Yes: HSN, exchange, MassHealth Standard/ CarePlus if income eligible Eligible for all 
Visas: work, student Yes: HSN if income eligible, private via exchange
No: MassHealth, CommCare 
Yes: HSN if income eligible, private via exchange
No: MassHealth Standard/ Care Plus 
Yes: Private via exchange
No: Medicaid 
Legal permanent residents (<5 years in US) Yes: HSN, CommCare if income eligible, private via exchange/carrier if >300 percent FPL
No: MassHealth 
Yes: HSN, ConnectorCare if income eligible, private via exchange/carrier if >300 percent FPL
No: MassHealth 
Yes: private via exchange if income < 400 percent FPL
No: Medicaid 
Legal permanent residents (>5 years in US) Eligible for all Eligible for all Eligible for all 
Naturalized and US-born citizens Eligible for all Eligible for all Eligible for all 
Coverage Based on Citizenship StatusMA: Ch. 58 (Pre-ACA)MA: Post–ACA ImplementationACA in Most States
Undocumented Yes: HSN if income eligible,
exchange 
Yes: HSN if income eligible
No: exchange 
No expansion 
Undocumented deferred action recipients (DACA/Dreamers) Yes: HSN if income eligible,
exchange 
Yes: HSN if income eligible
No: exchange 
Yes: Medicaid expansion if income eligible and under age 18
No: if over age 18 
Temporary protected/special status: refugees, asylees Yes: HSN, exchange, MassHealth, CommCare if income eligible Yes: HSN, exchange, MassHealth Standard/ CarePlus if income eligible Eligible for all 
Visas: work, student Yes: HSN if income eligible, private via exchange
No: MassHealth, CommCare 
Yes: HSN if income eligible, private via exchange
No: MassHealth Standard/ Care Plus 
Yes: Private via exchange
No: Medicaid 
Legal permanent residents (<5 years in US) Yes: HSN, CommCare if income eligible, private via exchange/carrier if >300 percent FPL
No: MassHealth 
Yes: HSN, ConnectorCare if income eligible, private via exchange/carrier if >300 percent FPL
No: MassHealth 
Yes: private via exchange if income < 400 percent FPL
No: Medicaid 
Legal permanent residents (>5 years in US) Eligible for all Eligible for all Eligible for all 
Naturalized and US-born citizens Eligible for all Eligible for all Eligible for all 

Notes: HSN = Health Safety Net; CommCare = Commonwealth Care; FPL = Federal poverty level

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