Biden Admin to announce up to ~580K DACA recipients to become eligible for ACA coverage!

Last August, Ben D'Avanzo of the National Immigration Law Center wrote a guest post here at ACA Signups about the 23% of uninsured Americans who are immigrants, and the challenges in providing healthcare coverage for them. In it, he noted that:

...given the slow nature of congressional action, the Biden administration can take some important steps now. For example, HHS could make hundreds of thousands of DACA recipients eligible for ACA coverage through regulatory action. It could also build on its existing investment in outreach and assistance programs to fund more Navigators and other community organizations that are best suited for immigrant-focused enrollment work.

DACA, or Deferred Action for Childhood Arrivals, is a U.S. immigration policy "that allows some individuals with unlawful presence in the United States after being brought to the country as children to receive a renewable two-year period of deferred action from deportation and become eligible for an employment authorization document (work permit) in the U.S. To be eligible for the program, recipients cannot have felonies or serious misdemeanors on their records."

Unfortunately, as referenced by D'Avanzo last year:

Deferred Action of Childhood Arrivals, or DACA,-eligible individuals are not eligible for insurance coverage through the Marketplace, Medicaid or CHIP. Unless their state has established a state-funded health coverage program, their only opportunity to obtain affordable health insurance may be through employment.

As noted above, a handful of states do have their own programs to cover DACA recipients: New York provides coverage for ~42,000 DACA folks via Medicaid; Colorado has roughly 10,000 undocumented immigrants (including several thousand w/DACA status) enrolled via their OmniSalud program, and so forth. Hundreds of thousands of them who don't have employer-based coverage, however, have been pretty much screwed until now.

Well, lo & behold, via Amanda Seitz & Michael Balsamo of the AP:

President Joe Biden is set to announce that his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants brought to the U.S. illegally as children, according to two U.S. officials briefed on the matter.

The action will allow participants in the Obama-era Deferred Action for Childhood Arrivals program, or DACA, to access government-funded health insurance programs. The officials spoke on the condition of anonymity to discuss the matter before the formal announcement on Thursday.

The 2012 DACA initiative was meant to shield from deportation immigrants brought to the US. illegally by their parents as young children and to allow them to work legally in the country. However, the immigrants were still ineligible for government-subsidized health insurance programs because they did not meet the definition for having “lawful presence” in the U.S. That’s what Biden’s Department of Health and Human Services will aim to change by the end of the month.

There's roughly 580,000 immigrants who have DACA status as of today. While all of them would presumably become eligible for ACA enrollment (and, therefore, federal ACA subsidies) via the change in their residency status, that doesn't mean 580K new ACA exchange enrollees. According to the Kaiser Family Foundation, around 39% of them are currently uninsured, or roughly ~230,000, give or take.The rest have other types of healthcare coverage just like most other Americans do.

Even among those ~230K, not all of them will necessarily qualify for financial subsidies as some may have too high an income, although I suspect that number will be minimal among this population. And of course some of them will become eligible for Medicaid instead. On the other hand, some of the other ~350K DACA recipients who are currently categorized as "insured" may have terrible coverage via short-term or other types of "junk" plans and thus may become eligible for ACA/Medicaid coverage as well.

The timeline on this change isn't certain--the AP article says that it would happen "by the end of the month" (late April) but I've also heard it could take up to six months (and there will likely be legal challenges which could potentially delay it further). Still, if it goes through reasonably smoothly, DACA recipients should be eligible to enroll in ACA exchange policies or Medicaid by this summer or fall, reducing the U.S. uninsured rate by several hundred thousand more people. That's the equivalent of a state the size of, say, Iowa or West Virginia expanding Medicaid in terms of potential coverage expansion.

UPDATE: HHS Sec. Xavier Becerra has issued a statement regarding the new DACA rule. Oddly it's available via email but not posted on either the HHS, CMS or White House websites as of yet:

HHS Secretary Xavier Becerra Statement on CMS Submission of Proposed Rule that Would Expand Access to Coverage for DACA Recipients

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra released the following statement today after the Centers for Medicare & Medicaid Services submitted a proposed rule that would expand access to coverage for DACA recipients:

“Today, the Centers for Medicare & Medicaid Services (CMS) submitted a proposed rule that expands access to health coverage by removing a barrier to health care faced by DACA recipients, known as Dreamers. If finalized, the rule would allow DACA recipients to enroll in Medicaid, the Children’s Health Insurance Programs (CHIP), and the Affordable Care Act’s Health Insurance Marketplaces.

Dreamers come from every corner of this planet, but the United States is their home. They are students, teachers, social workers, doctors, nurses, and more importantly, they are Americans. But, of the nearly 580,000 Dreamers who arrived in this country as children and currently have DACA protections, an estimated 34 percent do not have health insurance coverage. Today’s rule would change that.

The path to a prosperous life starts with having access to good health. And the path to a prosperous nation starts by extending access to health care to every American. Today’s announcement of the proposed rule would improve health outcomes for DACA recipients and would in turn improve the economic and productive capacity of America. It would also give these Dreamers and their families the peace of mind that comes with having access to care.

The Biden-Harris Administration continues to urge Congress to provide a pathway to citizenship for Dreamers and give them the ultimate peace of mind they need and deserve."

Not much additional detail here, though the 34% uninsured figure is a bit lower than the Kaiser Family Foundation estimates.