Letter to Honorable Joseph R. Biden, President of the United States and Honorable Norris Cochran, Acting Secretary of the Department of Health and Human Services - Congressman Cleaver Joins Rep. Castro, 93 House Colleagues Calling on President Biden to Expand ACA Access to DACA Recipients

Letter

Dear President Biden and Acting Secretary Cochran:
We write to respectfully request that the U.S. Department of Health and Human Services (HHS),
in response to the ongoing COVID-19 crisis, grant access to benefits under the Patient Protection
and Affordable Care Act (ACA) for Deferred Action for Childhood Arrivals (DACA) recipients.
Access to COVID-19 testing and treatment for DACA recipients and their U.S. citizen children is
absolutely critical during this pandemic, particularly for the 202,500 DACA recipients employed
as essential workers on the frontlines to keep our country healthy and running.1
Specifically, we request that HHS repeal 45 C.F.R. § 152.2(8), which excludes DACA recipients
from the definition of "lawfully present" and, consequently from benefits under the ACA, even
though DACA recipients are treated as lawfully present for other federal programs.
2 Fixing this
incongruity within the first 100 days of the administration is critical as any additional delay in
health care access during the COVID-19 pandemic puts the health of DACA recipients, their
families, and the wider community at risk.3 HHS should then follow up by issuing a State Health
Officials letter clarifying their eligibility for Medicaid and CHIP. It is crucial that you both keep
your commitment to expanding coverage for undocumented immigrants, including DACA
recipients, and rescinding this harmful regulation will help deliver on that promise.4
As a result of the current regulation and guidance, DACA recipients cannot:
a) Obtain comprehensive health insurance under Medicaid or CHIP in their state;
b) Purchase health insurance in the ACA's health insurance marketplace, even at full cost
using their own funds; and c) Receive federal premium tax credits to make private health insurance affordable in the
marketplace (even though DACA recipients still file and pay federal taxes).
Making ACA coverage and financial assistance available to all persons granted deferred action,
including DACA recipients would advance the goals of the ACA and benefit the American people.
Under DACA, immigrant youth with long-term residency in the United States who satisfy a strict
set of criminal background and educational criteria are eligible for employment authorization and
protection from deportation.5 Rescission of 45 C.F.R. § 152.2(8) would grant access to the ACA
for the approximately 650,000 current DACA recipients and could ultimately benefit over a
million individuals as the DACA program resumes.6 The regulation excludes a significant pool of
young, healthy adults--the exact type of participants that Congress sought to encourage to secure
and purchase health insurance under the ACA. Moreover, the regulation potentially leads to worse
health outcomes for DACA recipients and their families by foreclosing access to health care,
including unsubsidized purchases on ACA health insurance marketplace.
We strongly encourage HHS to honor our country's promise of full integration and support of
DACA recipients, including access to affordable health care through the ACA by rescinding this
regulation. We anticipate your response within 30 days, and we thank you for your attention and
prompt response. If you have any questions regarding this request, please contact Kaitlyn Montan
at Kaitlyn.montan@mail.house.gov.
Sincerely,

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