INPUT NEEDED: New Rule Would Extend Health Coverage Access for People with DACA

The U.S. Department of Health and Human Services (HHS) recently proposed a new rule that would make people with Deferred Action for Childhood Arrivals (DACA) eligible for health coverage through Medicaid/Children's Health Insurance Program (CHIP) under certain circumstances. Pregnant people with DACA and minors with DACA will be eligible for this coverage if the state where they reside has elected to allow immigrants with lawfully present status to participate in the programs, as Kentucky has, under the CHIPRA § 214 option.

The new rule would also allow people with DACA to purchase Qualified Health Plans on the Marketplace, which is called kynect in Kentucky, with financial assistance. This rule would also close a gap in health coverage for an additional category of young immigrants who cannot be reunited with their parents and clarify the eligibility requirements for other immigrant groups. KEJC supports this proposed rule as a long-awaited step towards bringing Center for Medicare and Medicaid Services regulations into alignment with the Affordable Care Act (ACA) and agreement with one another, as well as a victory for human rights.

People with DACA have always been "lawfully present." The ACA designated the "lawfully present" standard in 2010, and HHS issued a rule defining all those granted deferred action as lawfully present. This definition was used to determine eligibility for Medicaid and CHIP under the CHIPRA § 214 option, along with other things. Ultimately, by the end of 2012, the Department for Homeland Security had created DACA, but HHS regulations explicitly carved out people with DACA from all insurance affordability plans. Removing this carve-out will bring HHS regulations into agreement with one another and into compliance with the plain language of the ACA.

Moreover, this is the right thing to do. Healthcare is a human right. Denying healthcare to lawfully present people creates a caste system. According to the Kaiser Family Foundation, "47% of individuals likely eligible for DACA were uninsured, compared to 10% of U.S.-born individuals in their age group." to insure people with DACA is failing to cover preventive healthcare, which not only is inequitable, but also undermines public health initiatives and puts the rest of the country’s residents at risk. This NPRM would provide health coverage for an estimated 130,000 people, providing them with health resources before they resort to a costly hospital emergency room, which will ultimately save money for medical providers. Additionally, because many people qualify for Emergency Time Limited Medicaid and Disproportionate Share Hospital assistance in emergencies, this rule may ultimately save the government money.

A PUBLIC COMMENT PERIOD ON THE PROPOSED RULE RUNS THROUGH JUNE 23 AT 11:59PM. You can review the proposed rule and submit your own comment through the Federal Register website or by mail. Please note that if you do submit your comment by mail, HHS must receive it before the end of the comment period.

If you would like to make your voice heard without submitting your own comment, please complete the linked form by June 22 at 5PM. Kentucky Equal Justice Center (KEJC) will use your answers to help shape our comment. By completing the form, you are consenting for KEJC's comment to include quotes or paraphrased information from your responses.