BCS 207290 (02/10/2023)
Illegal immigrant not eligible for MA

DHA Case No. BCS 207290 (Wis. Div. of Hearings and Appeals February 10, 2023) (DHS) ↓ Download PDF

An applicant must be a U.S. citizen or qualifying lawful immigrant to be eligible for Medicaid. In this case, the petitioner applied for MA and was initially approved, but Homeland Security soon notified the agency that the petitioner illegally entered the country. Although the petitioner had applied for political asylum, he had not yet been granted that status. ALJ Brian Schneider concluded the petitioner was ineligible based on his unlawful immigrant status.

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Preliminary Recitals

Pursuant to a petition filed January 5, 2023, under Wis. Stat., §49.45(5)(a), to review a decision by Milwaukee Enrollment Services to deny Medical Assistance (MA), a hearing was held on February 8, 2023, by telephone.

The issue for determination is whether petitioner is an eligible immigrant for MA purposes.



Department of Health Services
1 West Wilson Street, Room 651
Madison, WI 53703
By: —
Milwaukee Enrollment Services
1220 W Vliet St
Milwaukee, WI 53205

Brian C. Schneider
Division of Hearings and Appeals

Findings of Fact

  1. Petitioner (CARES # —) is a resident of —.
  2. Petitioner applied for MA on December 19, 2022. He was granted eligibility under Department’s “reasonable compatibility” policy.
  3. On December 29, 2022 the agency received documentation from the Department of Homeland Security that petitioner illegally entered the country.
  4. By a notice dated December 30, 2022, the agency informed petitioner that MA would be denied because he was not a qualifying alien. MA has remained open, however, under the Department’s COVID emergency policy.


Prior to 1996, aliens lawfully admitted to the United States for permanent residence were eligible for MA immediately upon admission to the country. See 42 C.F.R. §435.406(a)(2). In 1996 the United States Congress made a number of changes to welfare law which included the restriction of alien eligibility for welfare programs. Generally, now, United States citizenship is required for a person to be eligible for MA. See Wis. Adm. Code, §DHS 103.03(2). An alien lawfully admitted for permanent residence is ineligible unless he meets one of several exceptions. Those exceptions are set out in §DHS 103.03(2) by their federal statutory citations, but they are detailed in the BadgerCare Plus Handbook, Appendix 4.3. The exceptions include refugees, asylees, Cubans, Haitians, Amerasians, military personnel, and veterans.

At this point petitioner has not been lawfully admitted for permanent residence, so he is ineligible for MA. He testified that he has applied for political asylum. While asylees are eligible, they have to have been granted that status. As petitioner has only applied for asylum, he has not yet been granted the status, and thus has not gained MA eligibility. I conclude, therefore, that the agency correctly sought close petitioner’s eligibility, although he will remain eligible until the COVID emergency ends.

Conclusions of Law

Petitioner is ineligible for MA because he is not a qualifying alien.



That the petition for review is hereby dismissed.

[Request for a rehearing and appeal to court instructions omitted.]

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