DACA Recipients Now Eligible to Buy Marketplace Plans

DACA immigration recipient buys health insurance after a change in healthcare Marketplace eligibility

13 Aug DACA Recipients Now Eligible to Buy Marketplace Plans

Posted at 08:00h in Health Insurance by Triage Cancer

Starting November 1, 2024, the U.S. Department of Health and Human Services will allow individuals with Deferred Action for Childhood Arrivals (DACA) status to sign up for State Marketplace health insurance plans.

What is DACA?

The DACA policy, established in 2012, protects children and young adults from being deported from the United States. Generally, in order qualify for DACA someone must:

Have been under 31 years old as of June 15, 2012;
Arrived in the United States before their 16^th birthday;
Have continuously resided in the United States since June 15, 2007, up to the time of filing their request for DACA;
Were physically present in the United States on June 15, 2012, and at the time of filing their request for DACA with USCIS;
Had no lawful immigration status on June 15, 2012, and at the time of filing their request for DACA;
Be currently enrolled in school, graduated, or obtained a certificate of completion from high school, or have obtained a General Education Development certificate (GED), or been honorably discharged from the armed forces;
And not convicted of a felony, significant misdemeanor, or otherwise pose a threat to national security or public safety.

What Has Changed?

A new rule from the Centers for Medicare and Medicaid Services (CMS), changes the definition of who is considered “lawfully present” in the United States.

Now, individuals with DACA status are considered “lawfully present.”

This means that they now may buy health insurance through a:

Qualified Health Plan (QHP) through a State Health Insurance Marketplace, with financial assistance through premium tax credit and cost sharing reductions; or
Basic Health Program (BHP) that offers coverage at a relatively low cost for people who do not qualify for Medicaid.

Financial assistance will come in the form of premium tax credits or cost-sharing reductions. Premium tax credits lower what an individual pays for their monthly premium. And cost-sharing reductions lower out-of-pocket expenses, such as co-pays and deductibles. The amount of your financial assistance depends on your household size and income.

For more information about on co-pays and deductibles, look at our Quick Guide to Health Insurance Basics.

For more information about Marketplaces, look at our Quick Guide to Health Insurance Marketplaces.

What are Some Key Tips?

Renewing DACA: Your DACA status must be valid at the time of enrollment and throughout your coverage period. Make sure you take into consideration the various renewal deadlines when considering your health insurance needs.
Immigration Status: It is likely that you will be asked to verify your immigration status for the Marketplace. Healthcare.gov has a list of acceptable documents that you can use in order to verify your immigration status here.

What are Some Key Dates?

November 1, 2024: Special enrollment period for DACA recipients begins.
December 1, 2024: Earliest possible start date for coverage for those who apply in November.
- Note: If you enroll on November 16, 2024, your coverage may not start until January 15, 2025.
November 1 – January 15, 2024: Open enrollment when people can enroll in a Marketplace health insurance plan. Be sure to double check the open enrollment dates in your state, because some states run their own Marketplace and extend the open enrollment period.

With this new rule, CMS estimates around 100,000 people who did not have health insurance before, may now be able to get it through a Marketplace plan or BHP.

For more information about health insurance, visit Triage Cancer’s Health Insurance Resources.

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through events, materials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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