Will Penalties Include DACA Recipients?

DACA recipients can't use the marketplace, and aren't required to pay the fee. Some state's allow Medicaid for DACA recipients.

In other words, DACA recipients are not eligible for health insurance under the Affordable Care Act (AKA DACA recipients are not eligible for ObamaCare and are "exempt" from its mandates). This is because they are not considered lawfully present for purposes of the Affordable Care Act. Therefore they do not have to pay the fee for having health insurance and can't get a marketplace plan with cost assistance.

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 own funding (this only applies to those recipients who meet the income requirements for Medicaid).

DACA recipients can take a "code C" exemption of form 8965 (see page 3) as per IRS guidelines (see question 11).

The final ruling on how Deferred Action for Childhood Arrivals (DACA) recipients are treated, in regards to the PPACA, can be found here:www.gpo.gov/fdsys/pkg/FR-2012-08-30/pdf/2012-21519.pdf

NOTE: In some states Deferred Action for Childhood Arrivals may be eligible for Medicaid. In these state's only state funding is used.

You can find everything you need to know about DACA recipients and ObamaCare from NILC.Org.

ACA-related federal regulations

♦♦ www.gpo.gov/fdsys/pkg/FR-2012-08-30/pdf/2012-21519.pdf ♦♦

• 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.
• Interim final rule adds 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.
  • Final rule on eligibility for the health insurance marketplace references 45 CFR § 152.2 for definition of “lawfully present”; so DACA-eligible individuals are excluded from eligibility to enroll in the marketplace.
  • 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).
  • 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.
  • 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.
  • Proposed rule on Basic Health Program (BHP) references 45 CFR § 152.2. Comments are due November 25, 2013.

Note we had to correct this answer a few times as information was sparse. The list above is from nilc.org.

Learn more on our page on Key Facts Regarding DACA Recipients and the Affordable Care Act.