Chicago – Attorney General Kwame Raoul, as part of a coalition of 18 attorneys general, defended a federal effort to expand health insurance access to Deferred Action for Childhood Arrivals (DACA) recipients.
Established in 2012, DACA enables certain young people, commonly referred to as Dreamers, who came to the United States as children and have lived in America continuously since 2007, to avoid immediate fear of deportation for revocable two-year periods. As of September 2023, more than 28,000 DACA recipients resided in Illinois.
Raoul and the attorneys general filed an amicus brief in support of a U.S. Department of Health and Human Services (HHS) and Centers for Medicaid and Medicare Services (CMS) rule for Medicaid and Affordable Care Act (ACA) eligibility that would make DACA recipients eligible to purchase health insurance through ACA exchanges. The rule is scheduled to take effect on Nov. 1, 2024. A group of states sued HHS and CMS in the U.S. District Court for the District of North Dakota and asked the court to delay implementation of the rule pending judicial review.
“Every day, Dreamers make invaluable contributions to our schools, workplaces and communities,” Raoul said. “Granting them access to purchase health insurance through the Affordable Care Act marketplace would lead to better health outcomes for them and improved public health for everyone.”
Separate regulations establish that individual DACA recipients may work lawfully in the country. They contribute an estimated $6.2 billion in federal taxes and $3.3 billion in state and local taxes each year and provide critical financial support to their families, including their over 250,000 U.S.-citizen children. They are employed by companies, nonprofit organizations, and government agencies and institutions, work in crucial roles in the medical profession and the U.S. military, are enrolled in public and private universities, and have started their own businesses that employ other residents, including U.S. citizens.
According to HHS, DACA recipients are three times more likely to be uninsured than the general U.S. population. DACA recipients previously lacked access to the ACA exchanges, even though Congress extended access to ACA exchanges to all who are “lawfully present,” a term that includes those whom DHS has temporarily allowed to remain without removal.
Uninsured populations drive up health care costs overall and worsen public health, resulting in increased premature deaths, uncompensated care costs, increased medical debt, reduced spending power, lost productivity, and absenteeism from work and school. Besides the obvious benefits to states that reduce the rate of uninsured populations, such as improved public health and better health outcomes, states that operate their own exchange, including Illinois, can benefit from including DACA recipients in their exchanges because larger and more diverse the risk pools may keep premiums lower for everyone.
Raoul and the coalition argue that principles of basic fairness require the court to deny the request to delay implementation of the rule, or at the very least, to narrowly limit relief and avoid a ruling that would negatively impact the health of millions nationwide. The brief emphasizes that most DACA recipients do not live in the states suing to block their health care access: two-thirds of Dreamers live in states that have not challenged the HHS rule.
In 2023, Raoul, along with many of the state attorneys general participating in this amicus brief, signed a comment letter to HHS in support of the rule. Joining Raoul in filing the brief are the attorneys general of California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont and Washington.
