Biden to open up Medicaid, Obamacare plans to DACA recipients

President Joe Biden on Thursday announced a plan to expand federal health care to hundreds of thousands of immigrants who came to the United States as children but do not qualify for government insurance plans because they lack legal status.

Under the proposed rule, nearly 580,000 people enrolled in the Deferred Action for Childhood Arrivals program will be able to obtain health coverage through Medicaid or the marketplace, two public health insurance programs for which undocumented immigrants are currently ineligible.

“Health care should be a right, not a privilege,” Biden said in a Thursday tweet. “My administration has worked hard to expand health care, and today more Americans have health insurance than ever. Today's announcement is about giving DACA recipients the same opportunity.”

HHS Secretary Xavier Becerra said in a statement that the proposed rule would “improve health outcomes for DACA recipients and would in turn improve the economic and productive capacity of America.” He estimated that roughly a third of immigrants enrolled in the DACA program are uninsured.

The details: The proposed rule submitted by CMS amends the definition of “lawful presence” to include DACA recipients, also known as “Dreamers,” for eligibility for Medicaid and marketplace coverage. Medicaid and exchange applications will have their eligibility verified electronically when they apply for coverage, the administration said.

While finalization of new rules usually takes some time, the Biden administration expects to have the new policy in place by the end of the month.

Context: President Barack Obama created the DACA program in 2012, shielding immigrants brought to the U.S. as children from deportation and allowing them to work legally in the United States. But DACA recipients have continued to lack access to key federal programs and benefits, such as health care coverage, because they lack permanent legal status.

Biden has focused on using his executive powers to protect and extend benefits to DACA recipients. And the president said on Thursday that he will continue to press Congress to create a path to citizenship for DACA recipients.

The moves represent a sea change from the approach taken by the Trump administration, which attempted to dismantle the DACA program.

State perspective: Several states, including California, New York and Minnesota, already cover DACA recipients through Medicaid. However, they have been unable to receive federal matching dollars for the coverage and have had to pull from their own state coffers.

Other states have taken creative approaches to expand health insurance access for immigrants, such as Colorado’s new OmniSalud program, which allows people to purchase health insurance through the state marketplace without disclosing their immigration status and potentially receive state subsidies to help with premium costs.