Key Facts Regarding DACA Recipients and the Affordable Care Act
In other words, DACA recipients are exempt from the Affordable Care Act’s coverage provisions (regarding mandates, regarding owing the fee for not having coverage, regarding using the exchanges, and regarding getting assistance).
Despite this, DACA recipients are extended other benefits, rights, and protections of the Affordable Care Act. For example, pre-existing conditions protections apply to anyone on a major medical plan.
Understanding the Details of DACA and the Affordable Care Act
Above is the gist regarding ObamaCare and DACA, below are some more key details about DACA and how it relates to the Affordable Care Act (ObamaCare).
What is a DACA recipient? DACA recipients are illegally present immigrants who were brought (or otherwise came) to the U.S. under the age of 16. They are protected by the executive order, and not law, as the DREAM Act that was supposed to protect them was never passed by Congress (and in reaction to this President Obama signed an order to protect them that was reversed by President Trump). DACA recipients receive a two-year renewable period of deferred action from deportation and eligibility for a work permit. Approximately 800,000 Dreamers were enrolled in the program as of 2017. DACA recipients are sometimes called “Dreamers” because of the relation between DACA and the dream act, the term refers to the idea that they are here working and living as Americans and “dream” of becoming citizens.
Do DACA recipients have to pay the fee or comply with ObamaCare’s mandates? DACA recipients can’t use the marketplace and aren’t required to pay the fee.
Can DACA recipients use any aspect of the ACA? In some states Deferred Action for Childhood Arrivals may be eligible for Medicaid. In these state’s only state funding is used. DACA recipients may also be affected by employer rules and benefits and protections offered by the ACA (they are exempt from marketplace cost assistance and the mandates, but general U.S. law, including that of the ACA, still applies to them, just like everyone else).
Can DACA recipients get health insurance? DACA recipients can however still obtain health insurance through their employer, through the private market outside of the marketplace, or obtain Medicaid in some states that allow for it and use their funding (this only applies to those recipients who meet the income requirements for Medicaid).
Are DACA recipients exempt from the mandate to get health insurance? DACA recipients are exempt from the mandate to get coverage, but they still have to file taxes (including the 8965 form). DACA recipients can take a “code C” exemption of form 8965 (see page 3) as per IRS guidelines (see question 11).
MYTH: It is a myth that DACA offers a pathway to citizenship. There is no way for most Dreamers to become citizens. DACA gave a temporary opportunity to those who came to the U.S. as children to stay, work, and pay taxes; it did not offer a pathway to citizenship. Learn more about DACA at CNN’s 5 DACA myths debunked.
MYTH: Its a myth that DACA recipients don’t pay taxes or work. DACA recipients tend to be employed and have paid about $2 billion in state and local taxes (the Institute on Taxation and Economic Policy estimates). Despite this, they don’t have access to marketplace cost assistance which legally present immigrants enjoy (including those here on work VISAs).
MYTH: It is a myth that all DACA recipients were brought here as kids. Anyone who came to the country illegally before age 16 and is currently under 31 qualifies for DACA. There are a lot of myths and misconceptions about DACA, and this only gets obscured by the ongoing debate over immigration in America.
The Official Sources on DACA and ObamaCare
The final ruling on how Deferred Action for Childhood Arrivals (DACA) recipients are treated, in regards to the PPACA (AKA ObamaCare), can be found here: www.gpo.gov/fdsys/pkg/FR-2012-08-30/pdf/2012-21519.pdf
Summary of the regulations: DACA recipients are not lawfully present thus they are excluded from eligibility to enroll in the marketplace and are excluded from eligibility to get heath insurance tax credits or out-of-pocket cost assistance. Because of this, they are also exempt from having to comply with the mandates and the fees.
ACA-related federal regulations
- Amends the definition of which immigrants are considered “lawfully present” for the high-risk pool (PCIP) by adding an exception for individuals granted deferred action through the DACA process. Individuals granted deferred action for other reasons will still be considered “lawfully present.”
- Issued as an interim final rule, effective August 30, 2012. A 60-day comment period ended October 29, 2012. Comments can be viewed at www.regulations.gov/#!docketDetail;D=CMS-2012-0138.
- The interim final rule adds an exception for DACA to Title 45 of the Code of Federal Regulations section 152.2 (45 CFR § 152.2) definition of “lawfully present” for PCIP eligibility.
- Other ACA rules reference the definition of “lawfully present” at 45 CFR § 152.2.
- The final rule on eligibility for the health insurance marketplace references 45 CFR § 152.2 for a definition of “lawfully present”; so DACA-eligible individuals are excluded from eligibility to enroll in the marketplace.
- The final rule on Health Premium Tax Credit references 45 CFR § 152.2 for definition of “lawfully present”; so DACA-eligible individuals are excluded from premium tax credits (also referred to as Advanced Premium Tax Credit, or APTC).
- The final rule on Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage and related exemptions references 45 CFR § 155.20, which references 45 CFR § 152.2; so DACA grantees are exempt from the individual mandate.
- The interim final rule indicates eligibility for cost-sharing reductions (CSR) will be the same as premium tax credits, as there is no rule on CSR yet.
- The proposed rule on Basic Health Program (BHP) references 45 CFR § 152.2. Comments are due November 25, 2013.