How to Do Outreach to Mixed Immigration Status Families

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Engaging Mixed Status Families

Mixed-status families refer to a family with members who have different legal status. While this term refers to families with both citizen and non-citizen parents and children, these families may consist of members with any combination of legal status. A prevalent situation is one in which the children have citizenship by being born in the U.S. and at least one parent is a non-citizen. Data shows that one-third of U.S. children who were born to immigrant parents live in mixed-status families.

More than 16 million people live in mixed-status families, with at least one person in the family undocumented. However, there are over 11 million undocumented people living in the United States. The make-up of these families varies widely and significantly impacts consumers’ comfort level when applying for programs that are available for them to due to fear for their family member’s immigration status.

  • Understand the Sensitivity: Individual’s legal status can be a subject of fear and vulnerability.
    • Do: exercise empathy and understand the severity and challenges families of mixed status will endure due to the fact some family members may be ineligible.
    • Don’t: assume you know a person’s legal status 
  • Avoid Probing Status Questions: Out of fear, a person who is undocumented often does not want to share their legal status with a stranger.
    • Do: provide eligibility requirements based on the categories provided by the U.S. Department of Health and Human Services.
    • Don’t: ask for an individual’s legal status or attempt to qualify if they fall under a legally sanctioned protected status.
  •  Provide Resources: Be sure to have a comprehensive conversation around where someone can get application assistance and local health care options.
    • Do: have a list of local health care resources available, and reassure that emergency care is still a federal provision regardless of legal status.
    • Don’t: promise or assure benefits that you are not certain will be afforded to a person/family.

If you do not know the answer to a specific question, be happy to say you do not know. Our role is to provide education about health coverage being available through the health insurance marketplace. You do not need to be an expert in everything! Make sure to note the consumer’s needs/questions/concerns for reference and follow-up as needed. Be sure to emphasize that if they have siblings or children who do qualify for coverage, you can get more information and encourage them to be enrolled.


There are many statuses that qualify an individual for coverage in the Marketplace. The following is a list of immigration statuses that qualify for Marketplace coverage:

  • Citizen
  • Lawful Permanent Resident (LPR/Green Card holder)***
  • Asylee
  • Refugee
  • Cuban/Haitian Entrant
  • Paroled into the U.S.
  • Conditional Entrant Granted before 1980
  • Battered Spouse, Child and Parent
  • Victim of Trafficking and his/her Spouse, Child, Sibling or Parent
  • Granted Withholding of Deportation or Withholding of Removal, under the immigration laws or under the Convention against Torture (CAT)
  • Individual with Non-immigrant Status (includes worker visas, student visas, and citizens of Micronesia, the Marshall Islands, and Palau)
  • Temporary Protected Status (TPS)
  • Deferred Enforced Departure (DED)
  • Deferred Action Status (Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying for health insurance)
  • Lawful Temporary Resident 
  • Administrative order staying removal issued by the Department of Homeland Security
  • Member of a federally-recognized Indian tribe or American Indian Born in Canada
  • Resident of American Samoa
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