For the first time since the law came into force Affordable Care ActUndocumented immigrants who were brought to the United States as children can purchase subsidized health plans through Covered California, the state’s insurance marketplace.

This move is expected to provide relief to thousands of people supposed dreamersespecially those who are freelancers, self-employed, or those without other health insurance.

But the expansion comes at an uncertain time, both because of Donald Trump’s decisions. vote as president and because of an ongoing lawsuit challenging the move to allow some undocumented immigrants to purchase health insurance through Affordable Care Act exchanges.

In his first administration, Trump tried unsuccessfully to roll back both the Affordable Care Act and the Obama-era policy. Deferred Action for Childhood Arrivals (DACA) protects certain undocumented immigrants.

California officials and immigration attorneys say it’s difficult to predict what will happen in the coming months, but eligible people should seize the opportunity and get health insurance as soon as possible.

“The release is here right now. So if you need to go to the doctor, if you’ve been putting off the care you need, if you’ve never had the opportunity to get preventative care, you can do it right now,” said administrator Jessica Altman. Director of Covered California. “Let’s not let fears about the future hinder what can happen and what you can achieve in the here and now.”

Altman and his team are traveling the state to spread awareness about the open enrollment period and This new access for DACA buyers.

DACA, created in 2012, does not give recipients legal status but protects them from deportation and grants them work permits. Until now, they were only allowed to sign up for health insurance through an employer. Low-income DACA donors in California can also register Medical.

Biden administration announced rule change In May, it updated the definition of “lawfully available” for Affordable Care Act eligibility so that DACA recipients can purchase insurance through federal or state insurance marketplaces.

“The rule corrects a long-standing error of exclusion,” said Nicholas Espíritu, deputy legal director of the National Immigration Law Center.

Espíritu explained that for Trump’s Health and Human Services department to roll back the rule, it would have to go through a similar administrative process that would include a notice and public comment period. This route can take quite a long time.

By some estimates, more than half a million people are protected by DACA, but it’s unclear exactly how many of them lack health insurance. A survey from UC San Diego and the National Immigration Law Center estimates about 20% uninsured. This is because most work permit holders can get coverage through an employer.

It is up to the federal government to expand coverage to DACA recipients. From $240 million to $300 million one year. However, since DACA recipients are young and the average age is 30, they could potentially make a positive impact. health insurance risk pool — Younger, healthier individuals could help lower premium costs for everyone enrolled in marketplace plans.

Covered California estimates that approximately 40,000 DACA recipients residing in this state are eligible for marketplace coverage this enrollment season. Open registration began November 1 and will continue through January 31. People must enroll by December 31 if they want coverage to begin January 1. DACA recipients will also be eligible for December 2024 coverage if they enroll before the end of this month.

GOP states oppose expansion of Affordable Care Act

The most immediate threat to Dreamers’ access to the Affordable Care Act is playing out in a courtroom in North Dakota. In August, a group of 19 Republican attorneys general from Kansas, Alabama, Florida, Texas, Idaho and other states filed a case challenging in federal court Expanding the insurance market to include DACA recipients.

They argue that allowing DACA donors into the marketplace creates “additional administrative and resource burdens” on states that operate their own exchanges. They also argue that access to subsidized health care would encourage undocumented immigrants to remain in the United States and could eventually lead to more illegal immigration.

California and 18 other states filed a brief last month to advocate for an expansion of Biden benefits.

“Dreamers pay billions of dollars in taxes each year to help fund programs like the Affordable Care Act. So far, they have not been able to access these programs themselves,” California Attorney General Rob Bonta said in a statement. “California, home to more Dreamers than any other state in the country, is proud to defend their right to access affordable healthcare.”

DACA donors in California pay an estimated amount $2.1 billion per year federal taxes Another $1 billion in state and local taxes, according to figures from the Center for American Progress.

Biden’s health subsidies may end under Trump

Arguably no other state has done more than California to expand health insurance coverage for its residents, including immigrants. The federal government’s move to open insurance markets to Dreamers complements California’s efforts.

The state is already offering Medical low income coverage Winners regardless of their immigration status. But thousands of workers earning above the Medi-Cal income limit I don’t have many options For affordable coverage. Undocumented individuals can technically purchase a health insurance plan directly from a broker in the private market, but this is without any financial assistance, making it unaffordable for many.

One way Trump and the new Republican-led Congress could undermine the Affordable Care Act for everyone, not just DACA recipients, is by not renewing the “increased premium subsidies” provided by the Inflation Reduction Act, health policy experts say. It will expire at the end of 2025. Improved subsidies increased the amount of financial aid available to people already receiving it and, for the first time, made it available to others by capping the amount they paid for an annual premium. up to 8.5% of standard plan revenues.

The increased cost of insurance coverage will likely cause some people to lose health insurance. Congressional Budget Office predictions 4 million people will fall across the country their scope in 2026 unless Congress acts to expand subsidies.

It’s unclear whether Trump will go after the Affordable Care Act again. Past Republican efforts to repeal the health care law have failed, but Trump succeeded in his first term. to eliminate or replace parts from him.

California health leaders say they are in talks about how to prepare for potential federal decisions that could impact the situation earnings in coverage area made by california.

“We’ve made such progress, and it’s been incredible and it’s been a challenge,” Covered California’s Altman said. “Even throughout the pandemic Medi-Cal redeterminations We are at the lowest uninsured rate on record. We have reduced our uninsurance rate more than any other state in the country.

“And I’m actually just thinking about … how can we continue to move forward on our mission, whether there are headwinds or tailwinds,” he said.

Ana B. Ibarra, CalMatters

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