A legal challenge has thrown a recent Affordable Care Act expansion into limbo. But, for now, DACA recipients, or "Dreamers," can still enroll in marketplace coverage while the battle plays out.
Deferred Action for Childhood Arrivals is a Obama-era program that protects from deportation immigrants brought into the U.S. as children without required documentation.
This year, for the first time, Dreamers and immigrants of certain other statuses were able to sign up for health insurance under the Affordable Care Act under a directive by the Biden administration in May.
But 19 states, including Florida, challenged the expansion.
One of the group's arguments is that ACA coverage will encourage illegal immigration by those who believe "they or their family members will be eligible for DACA in the future."
On Dec. 9, a federal judge in North Dakota issued a preliminary injunction in their favor. The Biden administration quickly challenged that decision, and the 8th U.S. Circuit Court of Appeals on Monday issued a stay that allows enrollment to continue while it hears the case.
Health navigators are encouraging people to sign up while they can.
"Unless otherwise communicated to us that it is otherwise ruled as unlawful, we are going to continue to enroll consumers who are deferred action childhood arrivals," said Xonjenese Jacobs, director of Florida Covering Kids & Families.
Open enrollment has been underway since Nov. 1. DACA recipients and others covered under the new expansion can choose a plan until Dec. 31 during the special enrollment period.
After that, they can still enroll until Jan. 15 as part of regular open enrollment and have their coverage begin on Feb. 1.
What led to this point?
The ACA, also known as Obamacare, extended access to affordable health insurance plans to millions of people when it was implemented about a decade ago.
But up until this year, that coverage was barred from those protected under DACA.
On May 3, the Biden administration announced a rule change — which is now being challenged — that reclassifies what it means to be "lawfully present," expanding ACA coverage to DACA recipients. It also applies to other immigrants, such as those younger than 14 with a pending asylum application.
"It really gives them the opportunity to have peace of mind that getting sick doesn't result in a financial catastrophe for themselves and their family," said Shelby Gonzalez, vice president for immigration policy at the Center on Budget and Policy Priorities.
That means people will be "less likely to delay care [and] people are more likely to get preventative services," Gonzalez adds. "They have better access to health outcomes in general."
The new rule, if the appellate court upholds it, could help more than 100,000 people, according to the Department of Health and Human Services.
Florida is home to about 21,000 DACA recipients, the fifth most of all states.
DACA grants recipients with legal work authorization, so some are able to receive health insurance from their employers. However, this community remains disproportionately uninsured, advocates point out.
According to a survey conducted by the National Immigration Law Center, about 20% lacked any health insurance or health care plan.
"It could be the different types of work that they do. Some industries are more likely than others to provide employer-sponsored insurance," said Gonzalez. "In other cases, they might be working part time, or they might be in school full time."
Some immigrants remain hesitant to sign up
The expansion can act as a safety net for those who lack insurance. But the challenge for advocates is outreach and breaking through the hesitancy to access public resources, said Gonzalez.
"A lot of barriers are in place to getting the full potential of everybody to enroll," she said. "People might be fearful of interacting with the government."
Jacobs, from Florida Covering Kids & Families, said the agency is trying to cut through some of the confusion about the lawsuit and how it may impact their coverage as well.
"There's been a bit of confusion around who's eligible, who's not eligible," said Jacobs, who has a doctorate in public health. "But what we're continuing to do is to make sure that we're providing the most quality and up-to-date information and education."
She's encouraging people to reach out and ask questions if they're not sure about their eligibility.
Advocacy groups including the National Immigration Law Center, United We Dream and Young Invincibles have launched a campaign "ACA4DACA" to raise awareness. They'll be working with 200 organizations across 41 states to encourage DACA recipients to sign up for health coverage.
"Our goal is to get as many eligible people enrolled as possible and fight back against the hateful, anti-immigrant actors already attempting to end this rule and stop thousands of people from accessing health care," said Juliana Macedo do Nascimento, deputy director of federal advocacy for United We Dream.
DACA and ACA appear to be under threat
Not all those who are eligible for DACA have applied for the program. In Florida, an estimated 53,000 people are eligible, though only 21,170 are active, according to 2023 data from the Migration Policy Institute.
The DACA program itself is in the midst of its own legal battle that has prevented new applications from being processed since 2021. Existing DACA recipients are still able to renew their permits every two years.
There is further uncertainty about the program under the incoming Trump administration.
The president-elect named immigration hard-liner Stephen Miller as deputy chief of staff. Miller had previously said Trump would try to end the DACA program if reelected. However, Trump recently told NBC News that Dreamers should bne allowed to stay and he wanted to work with Democrats on it.
Subsidies that lower premium costs under the ACA also face uncertainties under a second Trump term.
How to sign up for coverage
Visit healthcare.gov to enroll.
If you need help signing up for a plan, you can schedule an appointment with a navigator on CoveringFlorida.org or call 877-813-9115.
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