The proclamation that would have required insurance for immigrant visa applicants was blocked in court and revoked in 2021. One category still has a hard requirement.
There is no federal law requiring H-1B, L-1, O-1 or other employment-visa holders to hold health insurance. The ACA individual mandate penalty has been $0 since tax year 2019.
Coverage comes from your employer if they offer it, or from the individual market if they do not.
That is the legal position. The practical position is different: US healthcare without insurance is ruinously expensive, and an uninsured hospital admission can produce a bill larger than a year's salary.
22 CFR 62.14 mandates insurance for J-1 exchange visitors and their accompanying spouses and dependants, at these minimums:
| Cover | Minimum |
|---|---|
| Medical benefits | $100,000 per accident or illness |
| Repatriation of remains | $25,000 |
| Medical evacuation to home country | $50,000 |
| Maximum deductible | $500 per accident or illness |
| Maximum co-insurance | 25% of covered benefits |
This is a condition of the J-1 programme. Failure to maintain it is a programme violation, not merely an inconvenience.
Worth setting out because it still circulates as current.
Signed 4 October 2019, due to take effect 3 November 2019. It would have suspended entry of immigrant visa applicants who could not show they would be covered by approved health insurance within 30 days of entry, or had the financial resources to pay foreseeable medical costs. It did not apply to nonimmigrant work visas.
It was preliminarily enjoined by the District of Oregon in November 2019 and never took effect. The Ninth Circuit declined to lift the injunction.
It was revoked outright by Proclamation 10209 on 14 May 2021.
Current status: revoked, and we found no evidence of reinstatement. We searched specifically for a revival in 2025 or 2026 and found none. We state that as the absence of evidence rather than as a categorical negative.
Yes. Healthcare.gov lists "Individual with Non-immigrant Status including workers visas (such as H1, H-2A, H-2B)" among those who may buy Marketplace coverage.
DACA recipients cannot.
Buying coverage and being subsidised for it are different things, and the subsidy rules are narrowing.
Plan year 2026: premium tax credits eliminated for lawfully present immigrants under 100% of the federal poverty level who are Medicaid-ineligible because of their status — principally permanent residents within the five-year bar.
Plan year 2027: premium tax credit eligibility narrows to three groups only — lawful permanent residents, certain Cuban migrants, and COFA migrants from Micronesia, the Marshall Islands and Palau. Refugees, asylees, trafficking and violence victims, SIJS recipients, humanitarian parolees, TPS holders and deferred-action holders lose access. CBO estimates around 1.3 million people losing coverage.
We could not confirm whether nonimmigrant work visa holders retain premium tax credit eligibility from plan year 2027. The three retained categories are all immigrant or quasi-immigrant. The natural reading is that work visa holders lose the subsidy while keeping the right to buy unsubsidised Marketplace coverage — but we are not asserting that without the final implementing rules. If this affects you, check with a navigator or broker for the plan year in question.