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Biden moves to expand health care coverage for "Dreamers" in DACA program

Washington — The Biden administration on Thursday announced a regulation that would make nearly 600,000 immigrants who arrived in the U.S. as children but lack legal immigration status eligible for government-subsidized health insurance programs.

The proposed Department of Health and Human Services (HHS) rule would allow those enrolled in the Obama-era Deferred Action for Childhood Arrivals (DACA) program, also known as "Dreamers," to obtain coverage under Medicaid and the Affordable Care Act, if they meet other eligibility rules.

Established in 2012 to protect unauthorized immigrants brought to the U.S. as minors from deportation, DACA allows beneficiaries to live and work in the country legally on two-year increments. It does not give them permanent legal status or a path to U.S. citizenship.

Because they lack permanent legal status, DACA beneficiaries do not qualify for most federal benefits. The proposed HHS rule, however, would alter the definition of "lawful presence" for Medicaid and Affordable Care Act eligibility to give DACA recipients access to these programs.

"If finalized, the rule will make DACA recipients eligible for these programs for the first time," the White House said. "Under the proposed rule, DACA recipients will be able to apply for coverage through the Health Insurance Marketplace, where they may qualify for financial assistance based on income, and through their state Medicaid agency."

The Biden administration's action comes as DACA recipients and their advocates brace for a ruling from a federal judge in Texas who is reviewing the legality of rules enacted last year to transform the decade-old program into a regulation.

Texas and several other Republican-states are asking U.S. District Court Judge Andrew Hanen to once again declare DACA unlawful and terminate the policy over a two-year period. The program has been closed to new applicants since 2021, when Hanen first ruled it was illegal.

The White House said the proposed HHS rule is part of a broader Biden administration commitment to lowering healthcare insurance costs and expanding coverage "so that every American has the peace of mind that health insurance brings."

"The President's announcement gives DACA recipients that same opportunity, as the Administration continues to urge Congress to provide a pathway to citizenship to Dreamers, providing them the ultimate peace of mind they need and deserve," the White House added.

As of the end of 2022, there were 580,310 immigrants enrolled in DACA, according to . The program requires applicants to meet several eligibility rules, including having arrived in the country by age 16 and before June 2007, studying in a U.S. school or serving in the military and lacking any serious criminal record.

While Dreamers enjoy bipartisan support in Congress and among the American public, a rarity in the immigration debate, Thursday's announcement could invite legal challenges and criticism from conservatives.

In the lead-up to the passage of the Affordable Care Act in 2010, Republican lawmakers were adamant about making sure the proposal would not benefit immigrants living in the U.S. without legal permission.

In 2009, when then-President Barack Obama was pushing his health care reform in a speech before Congress, Republican Rep. Joe Wilson violated decorum to shout "you lie!" after Obama said the proposal would not benefit those living in the country illegally.

Ed O'Keefe and Steven Portnoy contributed to this report.

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