Older immigrants are one of the demographic groups which will be affected adversely by the White House’s planned repeal of the Affordable Care Act. The ACA offered a guaranteed-issue private-insurance option for recently arrived older non-citizens, a population which cannot access Medicare and which is eligible for Medicaid in only a handful of states.

The ACA stipulated that older new-immigrant adults – like their younger counterparts – cannot be denied coverage because of pre-existing conditions. It also limited the amount which elder enrollees may be charged in premiums, and it made available tax credits, in certain cases, to offset the cost of purchasing private coverage.

Almost 12% of Americans over age 65 claimed to be foreign-born at the time of the last national census, in 2010. This population grew by 70% between 1990 and 2010, in part because of the aging of long-time foreign-born residents, but also as a consequence of national immigration policies supporting refugee access and family reunification. These numbers are expected to grow even more in the coming decades.

Newly arriving older immigrants do not meet the residency requirements most states have established for Medicaid eligibility. As a group, they tend to have lower incomes and far less in savings that their non-immigrant counter-parts, and they’re far less likely than native-born residents to access available social services. Cultural and linguistic isolation can add to their vulnerability.

Compared with the rest of the nation, New York offers a far greater range of coverage instruments to facilitate healthcare access for new-immigrant elders. But elsewhere across the US, for the tens of thousands of foreign-born grandparents, aunts, and uncles seeking to join their naturalized US families, healthcare.gov has provided one of the only options.

Healthcare coverage for newly-arriving elders is particularly important in New York City, home to the largest foreign-born senior population of any US city. Almost half the city’s estimated one-million seniors are foreign-born, and in some neighborhoods, immigrants account for the vast majority of all seniors. Newly arriving Asians, Caribbeans, and Latinos are the fastest growing segment of the city’s over-65 population.

As debate gets under way for a national program to replace the ACA, bipartisan support exists for retaining some components of the original plan. New-immigrant elders need to remain on the radar as revisions go forward.

Note: New enrollment is closed, but you can find more information about the Affordable Care Act by logging on to www.healthcare.gov.