States Unite to Protect Health Insurance Access for Dreamers

Attorney General Anthony G. Brown announced today that Maryland, along with 13 other states, is taking legal action to safeguard health insurance access for Dreamers amid potential policy shifts by the incoming administration. This coalition seeks to defend a key health regulation under the Affordable Care Act (ACA) that extends coverage to those protected under the Deferred Action for Childhood Arrivals (DACA).

DACA, initiated in 2012, provides certain undocumented immigrants, who arrived as children and have continually resided in the U.S. since 2007, relief from deportation and eligibility for work permits. The contested regulation, issued by the U.S. Department of Health and Human Services and the Center for Medicaid and Medicare Services in May 2024, enables Dreamers to purchase health insurance through ACA exchanges.

A legal challenge led by Kansas, arguing against the regulation's implementation, resulted in a mixed court ruling in August 2024. While some states experienced a halt, others, including Maryland, saw no change in the rule's enforcement, which officially began on November 1, 2024.

The incoming administration has expressed opposition to the ACA and DACA, indicating a likely halt in federal defense of the regulation. In response, the 14 states have filed a motion to intervene, emphasizing the significant contributions of Dreamers to the U.S. economy and public health. According to the Final Rule, Dreamers are notably at higher risk of being uninsured and disproportionately impact healthcare costs when lacking coverage.

The states involved in this legal action—Maryland, New Jersey, Arizona, California, Colorado, Delaware, Hawaii, Illinois, Michigan, Minnesota, Nevada, New Mexico, Oregon, and Vermont—argue that maintaining the rule not only benefits Dreamers but also stabilizes healthcare costs and insurance markets by broadening and diversifying risk pools.

Attorney General Brown highlighted the integral role of Dreamers in America, stating, "Dreamers should not be denied the opportunity to purchase high-quality, affordable health care coverage because of a decision their loved ones made for them when they came to the U.S." This legal initiative underscores a broader commitment to ensuring that all residents have access to necessary health services, irrespective of their immigration status.