The League signed onto a letter to Secretary Becerra of the US Department of Health and Human Services (HHS), urging HHS to allow recipients of the Deferred Action for Childhood Arrivals (DACA) program to enroll in health insurance through the Affordable Care Act (ACA), Children’s Health Insurance Program (CHIP), and Medicaid.
October 25, 2022
Dear Secretary Becerra,
As advocates for immigrants and expanded access to health care, we urge you to allow recipients of the Deferred Action for Childhood Arrivals (DACA) program to enroll in health insurance through the Affordable Care Act (ACA), Children's Health Insurance Program (CHIP), and Medicaid. Under the Affordable Care Act, all people with lawfully present immigration statuses–which includes people granted deferred action–are eligible for enrollment in qualified health plans. Similarly, under the CHIP Reauthorization Act of 2009 states can elect to cover lawfully present children and pregnant people in Medicaid and CHIP. However, in 2012, the Department of Health and Human Services (HHS) decided that grantees of deferred action under the DACA policy memo would not be considered lawfully present for these coverage options, despite the absence of any statutory exception.
Now that the Department of Homeland Security’s (DHS) 2012 memo establishing DACA will be replaced by a final regulation, it is time for HHS to address this decade-long disparity. In the preamble to the new final rule, DHS states that, with respect to the programs under its jurisdiction, “DACA recipients are provided deferred action and should continue to be deemed ‘lawfully present’ like all other deferred action recipients—as they have been since the start of DACA.” However, DHS also notes that, “any future revision of this determination for Medicaid, CHIP, or with respect to the ACA Exchange and private market programs would need to be made by HHS.” Doing so not only would be consistent with DHS’s interpretation, it would advance President Biden’s policy priorities, such as Executive Orders 13985 on racial equity and 14070, strengthening access to health care. By making people with DACA eligible for insurance programs, HHS can extend coverage to hundreds of thousands of people without action from Congress.
People with DACA face deep health care disparities: 39% of DACA eligible individuals are uninsured, more than three times the rate of the general population. One survey found that 47% of people with DACA delayed care because of their immigration status and 67% said that they or a family member have been unable to pay medical bills. During the COVID-19 pandemic, DACA recipients disproportionately have served as essential workers, especially in the health care sector, despite lacking equitable access to protect their own health.
With pending court action, the future of DACA is uncertain, but that makes the imperative for HHS to act even more pressing. While other recipients of deferred action are eligible for these coverage programs, DACA recipients face the continuing consequences of uninsurance, such as unmet mental health needs and medical debt. Taking steps to improve people with DACA’s health and ability to participate fully in economic and civic life would help achieve the goals of the policy. Therefore, we ask you to act as soon as possible to issue the necessary regulations and guidance so that people with DACA can obtain the health care they need and deserve.
See attached letter for complete list of signatories