New Policies Expand Healthcare Opportunities for DACA Recipients

The US Department of Health and Human Services (DHHS) finalized a rule through the Centers for Medicare & Medicaid Services (CMS) that will expand healthcare access for Deferred Action for Childhood Arrivals (DACA) recipients under the Biden-Harris Administration. The rule will go into effect on November 1, 2024.

This rule will ensure DACA recipients' 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). It is estimated that more than a third of DACA recipients do not currently have health insurance. CMS anticipates that this rule could help 100,000 uninsured DACA recipients get coverage.

This new ruling will open a 60-day Special Enrollment Period for DACA recipients and other newly eligible people from November 1 to December 31, 2024. This timing coincides with the 2025 Open Enrollment Period.

Additionally, DACA recipients enrolling in a Marketplace plan may also qualify for advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSRs) to reduce the price of their Marketplace coverage. Eligibility for APTC and CSRs is dependent on the policyholder's income.

Aside from expanding access, the new DHHS rule modified the definition of "lawfully present" to improve administrative efficiency in determining eligibility for coverage through a Marketplace or BHP. These modifications will ensure exact and consistent eligibility and verification processes for people in search of new coverage.

Read the full rule here.