Is a 70-year-old lawful permanent resident eligible to buy ACA Marketplace plans immediately after receiving a green card?

1. Why a green card usually opens the Marketplace door — and what that means now

When an individual becomes a lawful permanent resident, that change in immigration status typically makes them a “lawfully present” immigrant eligible to enroll in Marketplace coverage. Current guidance treats green card holders as qualified noncitizens who may enroll through the exchange and, when income qualifies, receive premium tax credits and extra savings on out-of-pocket costs. This means a 70-year-old newly minted green card holder can sign up for a Marketplace plan right away, subject to enrollment timing rules and state-specific administration ^{[4] [5] [2]}. States administer Medicaid and exchanges differently, so while the federal framework permits enrollment, practical access and timing can vary by state contact points.

2. The special enrollment window tied to immigration changes — immediate access explained

Federal Marketplace rules create a 60-day special enrollment period triggered by certain life events, including obtaining lawful presence. Multiple sources indicate that obtaining a green card typically opens this immediate window to enroll through the exchange, allowing someone who lacked prior lawfully present status to buy a plan off-cycle rather than waiting for open enrollment. That special enrollment applies to the federal and state exchanges; off-exchange insurers may not be bound by that same trigger, which can affect the variety of plan options available to the enrollee ^[2]. The special enrollment path is therefore the clearest route for immediate coverage after receiving a green card.

3. Money matters: current subsidy eligibility and age-based premiums

Under current rules, premium tax credits and cost-sharing reductions are available based on household income and family size, and lawfully present immigrants generally qualify for those subsidies now. A 70-year-old’s premium rates may be higher because most states allow insurers to vary premiums by age (commonly up to three times the rate for younger adults), though some states restrict age rating. Thus a 70-year-old can both enroll and, if income-eligible, receive subsidies that reduce premiums and out-of-pocket costs; actual dollar amounts depend on the person’s income, state rules, and plan choices ^[1]. Contacting the exchange will provide plan-specific price quotes.

4. The 2027 policy shift: what will change and who is affected

Legislation set to take effect January 1, 2027, narrows which lawfully present immigrants can receive subsidized Marketplace coverage. Under that change, not all categories of lawfully present immigrants will qualify for federal premium subsidies; the framework will continue to permit certain groups such as lawful permanent residents, Cuban/Haitian entrants, and COFA migrants to be eligible, but the broader set of lawfully present statuses seen today will be curtailed. That means a newcomer who enrolls and receives subsidies today might face different rules for renewal or future enrollments after 2026, so longer-term financial planning should account for that pending cutoff ^{[3] [1]}.

5. Medicare, Medicaid, and other coverage traps for older immigrants

Age alone does not automatically confer Medicare eligibility for new immigrants; Medicare Part A premium-free status requires work credits, and new green card holders often lack the 40 quarters of payroll-taxed work necessary. As a result, a 70-year-old new LPR may be ineligible for premium-free Medicare and therefore rely on Marketplace coverage unless they qualify for Medicare by other means. Medicaid and CHIP have different rules by state; some states waive the five-year bar for certain immigrants, but many do not. Green card receipt does not equal Medicare access, and dual pathways must be checked with state agencies ^{[6] [4]}.

6. Practical next steps and where to verify your status and subsidies

To enroll quickly and confirm subsidy eligibility, contact the state or federal Marketplace immediately to trigger the special enrollment period and get income-based quotes; also check the state Medicaid agency for any immediate coverage options. Because administration details and state policies vary, documenting the green card issuance date and prior immigration status will be important at enrollment. Given the announced 2027 eligibility narrowing, ask the exchange about how renewals and future subsidy eligibility will be handled for your immigration category so you can plan for potential changes ^{[2] [3] [1]}.