As part of the Biden-Harris Administration’s ongoing commitment to ensuring affordable, quality health care for all, the U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), finalized a rule that will expand access to health care for Deferred Action for Childhood Arrivals (DACA) recipients. Today’s rule ensures 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). CMS estimates that this rule could lead to 100,000 previously uninsured DACA recipients enrolling in health coverage through Marketplaces or a BHP.
“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.”
Individuals without health insurance are less likely to receive preventive or routine health screenings and may delay necessary medical care, incurring high costs and debts when they do seek care. DACA recipients are currently three times more likely to be uninsured than the general U.S. population. 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 Marketplace 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 timing also corresponds with the 2025 Open Enrollment Period, which will help ensure that newly eligible individuals are able to seamlessly enroll in coverage. Those who apply for coverage in November 2024 can have their Marketplace coverage begin as early as December 1, 2024, if they meet all other eligibility requirements. DACA recipients and others who are eligible for a BHP can apply for and receive coverage as early as November 1, 2024.
CMS also made technical modifications to the definition of “lawfully present” used to determine eligibility for coverage through a Marketplace or a BHP to promote administrative efficiency, clarity, and transparency. These changes aim to ensure complete, accurate, and consistent eligibility determinations and verification processes for health coverage for these populations.
CMS is committed to providing high-quality education regarding implementation of this rule and technical assistance for the many interested parties who assist immigrant and other communities with health coverage enrollment.
All provisions of the final rule will be effective 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.
To view the final rule, visit the Federal Register.
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