A survey published last year by the immigrant rights nonprofit group National Immigration Law Center found that about 1 in 4 DACA recipients reported being uninsured.
Today, tens of thousands of DACA recipients became able to sign up for health insurance coverage under the Affordable Care Act for the first time.
The change — which coincided with the first day of the ACA’s open enrollment period — marks a pivotal moment for the more than 535,000 active DACA recipients in the U.S.
That lack of access, experts say, has led to high rates of uninsured among DACA recipients, sometimes referred to as “Dreamers.”
In May, the Biden administration finalized a rule that allows DACA recipients to apply for coverage through HealthCare.gov, as well as the state-based marketplaces, starting Nov. 1. It also lets them access subsidies that lower the cost of monthly premiums.
High uninsured rates
DACA was an executive action signed by then-President Barack Obama in June 2012 that protected undocumented immigrants who came to the U.S. as children from deportation and gave them work authorization.
For many, the ability to work also meant access to health insurance.
Without access to government-funded programs, insurance options are extremely limited for Dreamers who didn’t get coverage through their jobs, said Drishti Pillai, director of immigrant health policy at KFF, a nonprofit group that researches health policy issues.
Some turn to state programs for undocumented immigrants, she said. Others may go uninsured and rely on community health clinics that offer free or low-cost care.
While people can buy coverage directly through an insurer, the cost is often exorbitant and usually not an option for undocumented immigrants, Pillai said.
The limited options, she said, mean many DACA recipients can’t get quality health insurance, resulting in high uninsured rates.
A survey published last year by the immigrant rights nonprofit group National Immigration Law Center found that about 1 in 4 DACA recipients reported being uninsured.
“Now, they will have access to the same health insurance plans that other people do in the ACA,” Pillai said.
The change is expected to help more than 100,000 people get health insurance, according to a White House fact sheet.
DACA recipients, however, still won’t be able to get coverage through Medicaid or the Children’s Health Insurance Program, which offers free or low-cost insurance for kids and teens, Pillai said.
Legal challenges
In August, Kansas and 18 other states filed a lawsuit to block the ACA rule from taking effect. The suit was filed in a federal district court in North Dakota and was assigned to a judge appointed by former President Donald Trump.
The lawsuit says that expanding coverage to DACA recipients will create additional “resource burdens” and harm to taxpayers. It also says it will encourage undocumented immigrants to remain in the U.S. in hopes of receiving health insurance through the ACA.
Arthur Caplan, head of the Division of Medical Ethics at NYU Langone Medical Center in New York City, described the lawsuit as “just more anti-immigration politics.”
“The lawsuit is obnoxious and in many ways counterproductive to public interest,” he said. “It makes sense to get people into health insurance because they’re here and they’re going to show up to the ER if they get sick and you’re going to pay for them at higher prices.”
“It’s not like they’re not going to get health care anywhere,” Caplan added. “They’re going to get it most likely in emergency rooms, which are the most expensive setting.”
In a statement, Kansas Attorney General Kris Kobach, who is leading the legal effort, said: “The Biden administration’s effort to give Obamacare benefits to illegal aliens at taxpayer expense plainly violates two different laws. That is why Kansas went to court, and that is why we expect to prevail.”
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