Access to health care for low-income U.S. citizen children of international students


A change in Michigan Department of Human Services eligibility rules means that low-income U.S. citizen children whose parents have student visas or some other types of temporary legal immigration status can now qualify for Medicaid.  Those who have been denied in the past can reapply.


In January of 2012, the Michigan Department of Human Services changed its policy on Medicaid eligibility for the children of some non-citizens.  That policy, Bridges Eligibility Manual (BEM) 220, was about state residency.  It said that U.S. citizen children whose parents were not U.S. citizens but were on “temporary or time-limited” visas without employment authorization (work permits) could not be considered residents of Michigan.  Residency is required for Medicaid eligibility.  This mostly affected the children of legally present international students, many of whom have lived in the U.S. for many years and many of whom intend and are likely to continue living in the U.S. for many years.  It also meant that some U.S. citizens would be treated differently than other U.S. citizens because of the immigration status of their parents.

The Michigan Immigrant Rights Center (MIRC) filed a federal civil rights complaint in 2012 alleging national origin discrimination and other violations of law and regulation on behalf of a U.S. citizen child who was otherwise-eligible for Medicaid but denied coverage because of her mother’s student visa status. 

New Rule:

Effective January 1, 2014, the Michigan Department of Human Services has changed BEM 220.[i]  For the regular Medicaid program, the new rule does not contain any restrictions on the eligibility of U.S. citizen children that are based on the immigration status of their parents.  So, many children whose parents are international students with valid student visas who were not eligible before will now be eligible.[ii]  Those who were denied in the past may reapply. 

What parents can do:

Again, parents whose children have been denied in the past can reapply on behalf of those children.  Those who have not applied before may also apply.  If parents or advocates receive a denial that is based on “residency” or immigration status, they should request a hearing in writing from their county’s Department of Human Services immediately.   The denial notice should contain information about how to request a hearing.[iii]

Remember, this particular policy change only affects U.S. citizen children and the regular Medicaid health insurance program.  Children who are noncitizens with temporary legal immigration status based on their parents’ student status may have new health coverage options in the new health care marketplace created by the federal Affordable Care Act.  Visit for more information about that program. 

If you have questions or need assistance, please contact the Michigan Immigrant Rights Center at or (269) 492-7196 and let us know you are contacting us regarding the Medicaid program.

[i] The full text of the new rules can be found here: , visited January 13, 2014.

[ii] BEM 220 still contains the immigration status-related provisions for those seeking “SSI-related MA.”   SSI stands for Supplemental Security Income which is a federal program for people with disabilities.  MIRC remains engaged in advocacy on behalf of this much smaller part of the Medicaid-eligible population.

[iii] The Department of Human Services hearing request form is also available at: