For DACA Youth, Health Insurance is (Only) a Dream

By Dinah Wiley

[For insights into how President Obama’s Executive Order on immigration will impact health coverage for children and families, see these blogs by Sonya Schwartz and Joan Alker.]

We’ve received a lot of questions about the eligibility of young DACA grantees for health insurance.  It’s not surprising that there is confusion among immigrants and enrollment assisters about the eligibility of young non-citizens with the status of Deferred Action for Childhood Arrivals (DACA).  These uninsured immigrants are an exception to the general rule that non-citizens who are “lawfully present” are eligible for coverage under the ACA.  They are also the only immigrants with Deferred Action who are not eligible.

The Obama Administration created the DACA program to provide certain undocumented youth, usually called “DREAMers,” with the chance to work and to continue their education in the U.S. without fear of deportation (“removal”).  Removal action against these young adults may be deferred for at least two years, and extensions are available.  Under DACA guidelines, the young people must meet certain requirements, such as arrival in the U.S. before the age of 16, and current enrollment in school or the military.  Once granted DACA, they have permission to work and are eligible for a Social Security number and an employment authorization document (EAD).

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Individuals with Deferred Action are not “qualified” immigrants”and so are not eligible for full-scope Medicaid and CHIP.  However, the Administration also excluded those with DACA from affordable health insurance options for which others with Deferred Action are eligible.  The exclusion of DACA grantees from health insurance was issued as federal regulations and guidance effective August 30, 2012.

Under the policy, DACA grantees are not eligible to purchase health insurance in a Marketplace, even at full cost, and they are not eligible for federal tax credits to make private health insurance in the Marketplace affordable.  They are not eligible for the CHIPRA sec. 214 state option to cover lawfully residing children and/or pregnant women taken up by 29 states plus D.C.  They also are not eligible for the Basic Health Program if their state has this program.  Accordingly, DACA individuals are exempt from the individual responsibility requirement to have health insurance (the “mandate”).

DACA individuals have the same eligibility for health care and coverage as undocumented immigrants have.  They may be eligible for a separate, state-funded program available regardless of immigration status (such as “Medi-Cal” in California).  If their state elects a CHIP option to provide prenatal care regardless of status, then pregnant DACA grantees may receive care.  A chart  maintained by the National Immigration Law Center provides detailed information on state coverage programs.

Other access to care available to undocumented immigrants and to DACA grantees include limited emergency services paid for by Medicaid, including labor and delivery for childbirth.  Safety net programs that are available to all regardless of immigration status include immunizations, treatment at Community Health Centers and other Federally Qualified Health Centers (FQHCs), Migrant Health Centers, financial assistance or charity care at hospitals, insurance at full cost offered outside the Marketplaces, and employer-sponsored health insurance, if offered.

After encountering the DACA restriction on young immigrants’ ability to access health care, immigrants, navigators, and assisters frequently ask if and when the restriction will be lifted.  For more information on advocacy on behalf of DACA health care, go to

More about health care and immigrant families:

Getting Enrollment Right for Immigrant Families
Research Shows that Utah and Florida’s “ICHIA Option” Will Improve Access to Health Coverage and Services For Lawfully Residing Immigrant Children