Texas’ 90,000 DACA recipients can sign up for Affordable Care Act coverage — for now
When
After the appointment, she was told her immune system was attacking an overactive thyroid, a disorder called Graves' disease, and that an endocrinologist was the only doctor who could help her. But without health insurance, the cost to see one was exorbitant — as much as
"I thought it was a joke," said Elizondo, a 33-year-old restaurant owner.
Elizondo, who has been paying thousands of dollars a year for treatment, may soon find relief. She is now one of nearly 90,000 DACA recipients in
Advocacy groups say access to the marketplace will help alleviate the health disparities DACA recipients face, such as high uninsured rates and unmet medical needs after years of putting off care. However, a lawsuit threatens to take this eligibility away as
With premium tax credits that help lower health insurance costs set to expire at the end of 2025, Trump also has the ability to not renew them.
These subsidies, as well as cost-sharing reductions, are also now available to DACA recipients, lowering the amount they have to pay for premiums, deductibles and co-payments. DACA recipients cannot qualify for Medicaid, the public health insurance program for low-income individuals, under federal law. It's also unclear how many DACA recipients in
"More than one-third of DACA recipients currently do not have health insurance, so making them eligible to enroll in coverage will improve their health and wellbeing, and help the overall economy,"
Cost of health care
Elizondo pays about
Having health insurance would mean she could spend less time worrying about her personal costs and physical limitations and put more focus on her growing business.
"It's a big deal for me," Elizondo said.
According to the
"Right now, people are getting sicker because of [not receiving] preventative care. More folks will have to go to the emergency room," said
Espinosa would know. When he was an uninsured DACA recipient 16 years ago, he collapsed in front of his mother's door and was rushed by ambulance to the emergency room. He found out there that he had Type 2 diabetes.
Without health insurance, he had to rely on the
"I'm looking forward to also being able to afford a better quality of health care," he said.
Espinosa, now a permanent resident who also plans to enroll in federal marketplace insurance, hopes others take advantage of the new eligibility, particularly for their mental health needs. The law center report listed mental health as a top medical concern for DACA recipients, but 36% of them said costs were too high to access treatment. The uncertainty associated with the future of DACA is considered "a source of trauma, leading to increased fear, sadness, and distrust," according to the report.
"You can never be at peace," Espinosa said.
This distrust of public programs has motivated navigators, nonprofits that receive federal funding to help first-time enrollees sign up for Affordable Care Act coverage, to develop strategies to better help DACA recipients.
Navigators at health organization MHP Salud in
Eight days into open enrollment, Martinez said, MHP Salud had received five inquiries from DACA recipients through their online information form about coverage.
In July,
"We're going on a first date with DACA recipients," said
Fear of taking subsidies
According to health policy research organization
Since many DACA recipients are low-income and are generally barred from Medicaid, tax credits and cost-sharing reductions for marketplace plans could make the difference between having health insurance or not.
"The tax credits are huge," said
During his previous term, Trump had led an unsuccessful effort to get rid of the Affordable Care Act, and although he could renew the charge in his upcoming term, a more likely action is that he could whittle away subsidies that help low-income individuals afford a marketplace plan, regardless of their citizenship.
Further complicating the issue, DACA recipients also fear using subsidies could block their paths to citizenship. During the last Trump administration, federal officials broadened rules so that certain immigrants who received Medicaid, housing assistance, child care subsidies and other benefits for more than 12 months within any 36-month period could be deemed a public charge. Being labeled a public charge or a potential public charge carries high consequences: the inability to become a lawful permanent resident.
Espinosa said DACA recipients fear using Affordable Care Act subsidies will carry the same penalty.
"We tell them the truth and that this is not a public charge," he said. "They are not here illegally. They do have a permit to be here. We are hoping to be able to explain to people what this really means and hoping that they'll take a chance and do it."
An uncertain future
DACA recipients were originally excluded from the Affordable Care Act because they were not considered lawfully present. In a 2023 report,
"It relied on a desire to not interfere with immigration policymaking," Makhlouf wrote. "The decision to 'carve out' DACA beneficiaries from the category of lawfully present noncitizens was made under pressure from an administration that was concerned about appearing too lenient on immigration issues."
Those fears that the move would cause political pushback have been validated by a lawsuit, first filed in August, that seeks to reverse DACA recipients' eligibility for Affordable Care Act coverage. The attorney generals from 19 states, including
However,
DACA advocates say that health insurance coverage helps lower costs because people do not have to wait until their health problems become more serious and more expensive, possibly putting more financial burden on health systems.
Navigators say that federally funded clinics are the closest thing uninsured DACA recipients have to reliable quality health care.
"
Elizondo has been excited to sign up for Affordable Care Act insurance, listing out all the appointments she would like to make — those for regular health checkups, a gynecologist and mental health therapy. But with the results of
In the meantime, Elizondo, a decorated chef and owner of
"I have 17 employees, so it's like I have 17 children," she said. "The amount of energy it requires is high. Sometimes I feel like I'm not able to meet the demands the business requires."
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