Virginia expands Medicaid access for legal immigrants

RICHMOND, Va. — Ni Kin became a permanent resident in 2002 at 70 years old, but she was unable to work after moving from Myanmar to Virginia due to mobility problems.

Kin required more medical attention related to her condition as she aged, but was unable to see a doctor because she didn’t have insurance, according to her grandson Tin Myint. Kin didn’t qualify for Medicaid due to a state rule requiring permanent residents to present 10 years of work history to use public health insurance, Myint said. Kin also did not qualify for no-premium Medicare, since she never worked in the country and does not qualify for Social Security benefits.

“We have family friends who live in other states that were able to get Medicaid when they applied, who’ve been living here for 10 to 15 years, and we thought that applied to us also,” Myint said. “That was disappointing and shocking to hear that Virginia was one of the very few states that had this particular rule.”

Kin is one of thousands of permanent residents in Virginia who will qualify for Medicaid due to a new change eliminating the 10-year work history requirement, known as the “40-quarter rule,” according to the Virginia Poverty Law Center, a nonprofit group that advocates for low-income Virginians. The commonwealth was one of six states with a 10-year work history requirement for Medicaid.

Gov. Ralph Northam and state legislators approved a budget last year that eliminated the rule. The change went into effect this month.

Northam’s line budget amendment includes $4.4 million in state funds for this change, according to the Virginia Poverty Law Center.

Freddy Mejia, a policy analyst at the Commonwealth Institute, said the old rule was a roadblock for legal permanent residents. The Commonwealth Institute is an organization that analyzes the impact of fiscal and economic issues on low-income communities.

“Someone who comes to the country as an older adult, possibly doesn’t get the opportunity to work for 10 years but gets sick,” Mejia said as an example.

Mejia said lawmakers and advocates lobbied for the change in the 2019 General Assembly, but it did not pass. Northam and lawmakers approved the change as a line budget amendment in 2020, but it was vetoed once the COVID-19 pandemic began, Mejia said. It was funded again in the 2020 fall special session, and the change went into effect April 1, 2021.

Mejia credited this change to advocacy efforts from different parties, including the National Korean American Service and Education Consortium, the Virginia Poverty Law Center, and politicians such as Del. Mark Sickles, D- Franconia, Sen. George Barker, D- Alexandria, and Northam.

Jill Hanken, a health attorney and director of ENROLL Virginia, said immigrants have suffered in a disparate way throughout the COVID-19 pandemic, and the policy change will encourage people to apply for the coverage they need. ENROLL Virginia is a project of the Virginia Poverty Law Center that helps Virginians access affordable health coverage.

“Statewide it demonstrates that Virginia is welcoming and interested in making sure that immigrants have access to the health services that they need,” Hanken said.

ENROLL Virginia will continue alerting immigrants across the commonwealth of this change, Hanken said.

Meanwhile, Myint is excited to sign his grandmother up for Medicaid.

“I can’t wait for her to get proper medical checkup, the needs that she needs to have a living condition she deserves,” Myint said.

Capital News Service is a program of Virginia Commonwealth University’s Robertson School of Media and Culture. Students in the program provide state government coverage for a variety of media outlets in Virginia.