More than a quarter of DACA beneficiaries are uninsured as they await the fate of the healthcare rule

More than a quarter of immigrant youth protected by the Deferred Action for Childhood Arrivals program lack health insurance and face charges preventing them from accessing care, according to new data shared for the first time with NBC News.

A report released Friday by the non-profit group National Immigration Law Center, documenting the results of a recent survey, found that 27% of DACA recipients said they were not covered by health insurance or other health care plan. health.

Findings suggest that of the more than 580,000 young adults without legal status who are allowed to work and study without fear of deportation under the Obama-era DACA program, an estimated nearly 157,000 are uninsured. .

The survey was conducted last year among 817 DACA recipients. It was administered by Tom K. Wong, founding director of the U.S. Immigration Policy Center at the University of California, San Diego, with assistance from United We Dream, the nation’s largest immigrant youth-led organization, the Center for American Progress policy institute. and the National Immigration Law Center.

A previous version of the survey conducted in 2021 found that the DACA uninsured rate was 34%. Kica Matos, president of the National Immigration Law Center, attributed the slight drop to “a healthier economic climate.”

“The last survey was done while we were still in the middle of the pandemic, so we believe economic trends have since improved… This likely means there are more DACA recipients who are employed and have access to health care” through their employers, she said.

Of DACA recipients who reported having health insurance, 80% said they were covered by an employer or union.

But unlike most of the United States, if DACA recipients lose their jobs and with it their health insurance, they cannot fall back on federal health insurance programs, which are often more affordable but are only available for those with legal immigration status.

Because being ineligible for federal health insurance contributes to the high rate of uninsurance for DACA recipients, the Department of Health and Human Services under President Joe Biden proposed a rule that would expand the eligibility of DACA recipients. access to health care coverage. Research has found that DACA recipients pay approximately $6.2 billion annually in federal taxes that help fund such programs.

The Biden proposal calls for the definition of “legal presence” to be amended to include DACA recipients for the purposes of Medicaid coverage and the Affordable Care Act.

“There is a lot of hope for many of us to be able to access affordable health care because we often avoid going to the doctor,” said DACA recipient Diana Avila. “The thought of how much it’s going to cost is what makes a lot of us not want to go to the doctor.”

The proposed Biden rule has yet to be finalized, which means access for DACA recipients to federal health insurance programs is not yet a done deal.

In response to an email from NBC News, the Centers for Medicare and Medicaid Services, which submitted the proposed rule, said that “While we cannot speculate when the rule will be finalized, note that the rule includes a proposed effective date for all provisions of November 1, 2023.”

CMS will seek public comment until June 23 on the draft regulations, “and specifically on the feasibility of that date and whether to consider a different effective date,” it said. he declares.

Avila, 22, was born in Honduras and has lived in Indiana since she was 4, and was 12 when she obtained DACA in 2012.

Barriers to accessing health care

DACA beneficiaries are awaiting the fate of the proposed rule at a time when they are three times more likely to be uninsured than the general population, according to last year’s survey.

DACA has helped many eligible young immigrants access higher paying jobs and educational opportunities, but not all recipients.

“There are still significant disparities in access to health care for this particular population,” Matos said.

According to the survey, DACA recipients reported other barriers to accessing health care:

  • 57% of respondents believed they were not eligible for access to care due to their immigration status.

  • 51% said they were unaware of affordable care or coverage options available to them.

  • 21% believed that access to health services could negatively affect their immigration status or that of a family member.

Of those surveyed, 71% reported past situations where they were unable to pay medical bills or expenses.

On top of that, “there are also those memories of families who can’t afford health care and have to deal with bills,” Matos added.

Avila remembers growing up in a family with mixed immigrant status. This meant that she and her older brother could not access affordable health care while her younger, American-born siblings qualified for care.

As a child, Avila was prone to ear infections, she said. Her mother would use every possible home remedy to evade doctors and hospitals and avoid unaffordable medical bills. On the other hand, his younger brothers went to the doctor more often, even for the most minor problems.

When Avila was 18, she suffered a concussion while playing football at school and had to see a specialist. She remembers being hesitant to go because she was worried about herself and her family’s ability to pay for treatment.

“It’s sad to think about it. I considered not being watched, taken care of, because of the cost it was going to cost,” she said.

The uncertainty of DACA – and the mental health toll

Although DACA has been around for a decade, it has faced legal challenges from the Trump administration and Republican-led states. The program has been closed to new enrollees since July 2021, while a lawsuit filed by Texas and other GOP-led states makes its way through the courts.

To improve the chances of DACA surviving legal battles, the Biden administration implemented a rule in October that turned the program into a federal regulation. A Texas federal judge is expected to rule on the legality of the new rule this year.

“The precarious nature of DACA has led to feelings of anxiety, depression and fear related to the future of their status because it is so uncertain,” Matos said of DACA recipients.

The new report found that almost half (48%) of DACA recipients said they had mental or behavioral health problems, but did not seek care from a mental health professional. The top three barriers were high costs, lack of time, and limited access to providers able to meet their cultural or linguistic needs.

Avila recently earned a degree in psychology from Marian University in Indianapolis and works at a nonprofit organization serving immigrants.

Despite the uncertainty surrounding DACA, she plans to apply to law school and major in immigration law and human rights, hoping a more permanent solution to her immigration status emerges. .

“DACA recipients contribute so much to society, it’s time for a change,” Avila said. “A pathway to citizenship would be the best way to appreciate the work that DACA recipients have done since arriving in the United States”

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