Biden offered health insurance access to DACA immigrants. Trump took it away.

Sep. 19—A new Trump administration rule bars immigrants living in the United States under Deferred Action for Childhood Arrivals (DACA) from buying health insurance from Affordable Care Act marketplaces.

The change, announced in June, took effect at the beginning of this month. It reverses a policy change enacted by the Biden administration for last November's annual enrollment period.

DACA, which President Barack Obama established in 2012, applies to certain immigrants who are here illegally but were brought to the U.S. as children. The program was enacted to protect them from deportation and allows them to work for renewable two-year periods. To be eligible, an immigrant must have come to the U.S. at age 15 or younger before June 15, 2007. DACA participants also must be high school graduates, high school students or veterans of the U.S. military.

The oldest are now in their early 40s, some with children of their own.

Even though there are some 525,000 active DACA recipients, only about 10,000 were getting their health insurance from the marketplaces before the policy change, according to the federal Centers for Medicare & Medicaid Services. However, critics of the new Trump administration rule say participation would have grown as more people became aware of their eligibility.

DACA recipients from 19 states were blocked from the marketplaces, though, because of pending litigation. More than 20% of all DACA recipients reside in just two of those states: Texas (17%) and Florida (4%).

Jessica Vaughan, director of policy studies at the Center for Immigration Studies, a nonprofit group that backs stricter immigration rules, said DACA was an "abuse of executive authority" and should not have entitled some immigrants to benefits. The rule change simply restores the status quo, Vaughan said.

"It was kind of an experiment or an end run around our legal immigration system that was set up by the rules that were set up by Congress to try to offer an amnesty to this particular group," Vaughan said. "Because it's not a legal status, these individuals are not, under the law, eligible for certain public benefits, and one of them is subsidized health insurance."

But critics of the change say it's cruel to cancel health care coverage for people who were brought to the country as children.

"Health care is a fundamental human right all of us, no matter where we were born, how much money we have, what we look like, what language we speak, we should be able to access quality and affordable care when we need it," said Isobel Mohyeddin, a policy associate at the National Immigration Law Center, which advocates for immigrants.

The stripping of eligibility is a devastating step backwards, not only for DACA recipients, but families and immigrant communities in general. — Isobel Mohyeddin, policy associate at National Immigration Law Center

Mohyeddin and her colleagues surveyed 433 DACA recipients in 2024, before DACA recipients were eligible for the marketplace. Eighty-one percent had health coverage, the vast majority through their employer or a union or professional association. But nearly 20% lacked coverage, more than twice the national uninsured rate of 8%.

Mohyeddin said that many of the DACA recipients without coverage reported skipping recommended medical and dental appointments or declining to fill prescriptions, because they couldn't afford it or were fearful of being targeted for their status.

"The stripping of eligibility is a devastating step backwards, not only for DACA recipients, but families and immigrant communities in general," Mohyeddin said.

While DACA recipients were only recently allowed to purchase coverage on the marketplace, it was a huge step toward better health outcomes for them, said Arline Cruz Escobar, director of health programs at Make the Road New York, a group that provides legal and social services to immigrants.

"We see a lot of mixed-status households, and so I think people are just very confused about what this means for them, and what it means for their families," Cruz Escobar said. "We already know that the immigrant community doesn't access enough preventive care and screenings and so, I can only imagine that we will see an increase in a lot of chronic conditions, or undiagnosed chronic conditions that could have been prevented."

The impact of the new Trump administration rule on DACA recipients will vary, as some states offer other health care options to noncitizens.

States are going to have to decide whether they can afford to offer state-subsidized health coverage to DACA recipients and other immigrants who are no longer eligible for federal help, said Jessica Altman, executive director of California's marketplace exchange, Covered California.

California has the most DACA recipients, at 147,440. Altman said more than 2,300 of them have purchased plans on the California marketplace and will lose their coverage. She said many DACA recipients in the state were not aware of their eligibility, and more would have enrolled if the Trump administration hadn't made the policy change.

California provides state-funded health coverage to all income-eligible immigrants, regardless of their legal status. But Democratic Gov. Gavin Newsom in June signed a budget that scales back that coverage because of budgetary issues.

In light of federal changes and financial obligations on states, Altman said, California will have to make the same choices as other states about how or whether to help DACA recipients with their health care.

"The hard part is, to actually make coverage affordable for the populations that we're talking about, you have to fund financial assistance at least somewhat comparable to what's available on the federal marketplace," Altman said. "So the state dollars are really where the rubber meets the road."

Stateline reporter Shalina Chatlani can be reached at [email protected].

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