By Ivan Sanchez
The Deferred Action for Childhood Arrivals (DACA) program, established in 2012 under President Obama, offers temporary relief to undocumented individuals brought to the U.S. as children. Referred to as “Dreamers,” these individuals, despite lacking legal status, have grown up in the U.S. and consider it their home. DACA allows them to live, study, and work in the country without fear of deportation, providing stability and opportunity.
In line with the Biden-Harris Administration’s commitment to ensuring affordable and quality health care for all Americans, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), has finalized a rule aimed at expanding access to health care for DACA recipients.
The rule marks a significant milestone in addressing the health care disparities faced by DACA recipients. Under this rule, DACA recipients will no longer be excluded from eligibility to enroll in a Qualified Health Plan (QHP) through the Affordable Care Act (ACA) Health Insurance Marketplace or for coverage through a Basic Health Program (BHP). The CMS estimates that this rule could lead to 100,000 previously uninsured DACA recipients enrolling in health coverage through Marketplaces or a BHP.
HHS Secretary Xavier Becerra emphasized the administration’s dedication to making health coverage accessible for DACA recipients who have contributed to society in various capacities. Becerra highlighted that more than one-third of DACA recipients currently lack health insurance, underscoring the urgent need to expand access to coverage for this population.
Individuals without health insurance are less likely to receive preventive or routine health screenings and may delay necessary medical care, resulting in high costs and debts when seeking care. DACA recipients are currently three times more likely to be uninsured than the general U.S. population. Additionally, DACA recipients who qualify to enroll in a Marketplace plan may also qualify for advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSRs) to reduce the cost of their coverage, depending on their income.
As a result of this rule, DACA recipients and other newly eligible individuals will qualify for a special enrollment period to select a health plan through the Marketplace during the 60 days following the rule’s November 1, 2024, effective date. This aligns with the 2025 Open Enrollment Period, facilitating seamless enrollment in coverage. CMS has also made technical modifications to the definition of “lawfully present” to ensure accurate eligibility determinations and verification processes for health coverage for these populations.
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