Biden expands ObamaCare to Dreamers

May 3, 2024

The Biden administration on Friday morning announced a rule that will allow certain Dreamers to access the ObamaCare marketplace.

Under the rule, active recipients of Deferred Action for Childhood Arrivals (DACA) will be eligible to enroll in a qualified health plan or a basic health plan under the Affordable Care Act (ACA), and some forms of financial assistance.

“This final rule reflects the president’s key commitment to protecting Dreamers and DACA recipients. He is focused on providing them with the support they need to thrive and reach their fullest potential,” Neera Tanden, director of the Domestic Policy Council, told reporters Thursday.

“This final rule also reflects the president’s belief that health care is a right not a privilege for all Americans, that it should extend to DACA recipients just like the rest of us.”

The new rule comes after months of speculation over executive actions the Biden administration might take on immigration issues, from potentially cracking down on asylum at the border to making work permits available to certain undocumented immigrants.

Most of those potential actions are controversial to one side of the political spectrum or the other, but Dreamers, undocumented immigrants who arrived in the country as minors, have generally garnered broader public support than other undocumented groups.

Still, DACA is mired in lawsuits. Though the Supreme Court nixed the Trump administration’s efforts to end it, a Texas federal judge declared the initial memo that created it illegal, and that same judge in September ruled against the Biden administration’s efforts to recodify the program as a federal regulation.

The program’s final fate is likely to be decided by the Supreme Court, but for the time being, the federal government is barred from adding new beneficiaries to DACA.

As of September, there were 544,690 enrollees, though the Migration Policy Institute estimates that 1,161,000 people would be eligible for DACA as of 2022.

DACA recipients had previously been excluded from ObamaCare benefits, though other foreign nationals in deferred action programs were not.

Under previous Centers for Medicare and Medicaid Services (CMS) rules, DACA recipients were not “lawfully present” in terms of the health care law. That’s led a number of DACA recipients, particularly those without employer-provided insurance or the means to self-finance health insurance, to fall out of coverage.

CMS estimates that the new rule will lead to 100,000 newly eligible DACA recipients enrolling in either a marketplace plan or a basic health program.

“Dreamers as DACA recipients are currently three times more likely to be uninsured than the general U.S. population, and individuals without health insurance — I think we all know this — are less likely to receive preventative or routine health screenings,” said Health and Human Services Secretary Xavier Becerra.

“They delay necessary medical care, and they incur higher costs and deaths when they do finally seek care. So making Dreamers eligible to enroll in coverage will improve their health and well-being and strengthen the health and well-being of our nation and our economy.”

The rule will take effect on Nov. 1, when a 60-day special enrollment period will open for eligible DACA beneficiaries. Officials planned that period to coincide with open enrollment for other ACA users to simplify the process.

The new rule does not make DACA recipients eligible for Medicaid or parts of the Children’s Health Insurance Program, but they will be eligible for financial aid programs that are already available to noncitizens whose immigration status makes them ineligible for Medicaid but would otherwise qualify.

“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 in a statement.

“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.”