In line with the Biden-Harris Administration's commitment to affordable and high-quality health care for everyone, the U.S. Department of Health and Human Services, in collaboration with the Centers for Medicare & Medicaid Services (CMS), has finalized a regulation to broaden health care access for Deferred Action for Childhood Arrivals (DACA) recipients. This regulation ensures that DACA recipients are no longer excluded from enrolling in a Qualified Health Plan (QHP) via the Affordable Care Act (ACA) Health Insurance Marketplace or obtaining coverage through a Basic Health Program (BHP). CMS predicts that this regulation could result in 100,000 previously uninsured DACA recipients gaining health coverage through Marketplaces or a BHP.
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“HHS is committed to making health coverage accessible for people DACA recipients – Dreamers – who have worked hard to live the American Dream. Dreamers are our neighbors and friends; they are students, teachers, social workers, doctors, and nurses. More importantly, they are fellow Americans,” said HHS Secretary Xavier Becerra. “More than one third of DACA recipients currently do not have health insurance, so making them eligible to enroll in coverage will improve their health and wellbeing, and help the overall economy.”
“The Biden-Harris Administration believes health care is a right, not a privilege, and that extends to DACA recipients who have built their lives in the United States,” said CMS Administrator Chiquita Brooks-LaSure. “Today’s rule reduces barriers for DACA recipients to obtain health care coverage and is a vital step toward making certain that it is available and accessible to all Americans.”
People without health insurance often miss out on preventive health screenings and may postpone necessary medical treatment, leading to significant costs and debts when they eventually seek care. DACA recipients are currently three times more likely to lack health insurance compared to the average U.S. population. Those who qualify for enrollment in a Marketplace plan may also be eligible for advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSRs) to make Marketplace coverage more affordable, depending on their income.
With the implementation of this rule, DACA recipients and other newly eligible individuals will have access to a special enrollment period to choose a health plan through the Marketplace. This enrollment period spans 60 days starting from the rule's effective date of November 1, 2024, conveniently aligning with the 2025 Open Enrollment Period. Applicants in November 2024 can start their Marketplace coverage as early as December 1, 2024, provided they meet all other eligibility criteria. DACA recipients and other eligible individuals for a BHP can apply for and receive coverage starting November 1, 2024.
Additionally, CMS has made technical adjustments to the definition of "lawfully present" used in determining eligibility for Marketplace or BHP coverage. These changes aim to streamline administrative processes, enhance clarity, and ensure consistent and accurate eligibility assessments and verification procedures for health coverage among these populations.
CMS is dedicated to offering high-quality education on the implementation of this rule and providing technical support to various stakeholders assisting immigrant and other communities with health coverage enrollment.
All provisions of this final rule will come into effect on November 1, 2024.
For more information on the final rule, see the fact sheet at https://www.cms.gov/newsroom/fact-sheets/hhs-final-rule-clarifying-eligibility-deferred-action-childhood-arrivals-daca-recipients-and-certain.
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