Frequently Asked Questions: Affordable Care Act Eligibility for DACA Recipients

Frequently Asked Questions: Affordable Care Act Eligibility for DACA Recipients

May 2024

Gabrielle Lessard, Ben D’Avanzo, and Isobel Mohyeddin

People with Deferred Action for Childhood Arrivals (DACA) will be able to enroll in health coverage via Affordable Care Act marketplaces for the first time starting November 1, 2024. This FAQ answers key questions that DACA recipients may have about the enrollment process and addresses other concerns.

What kind of health insurance programs am I eligible for?

Starting November 1, 2024, if you have DACA you will be eligible to enroll in private health insurance plans through the health insurance marketplaces created by the Affordable Care Act (ACA), like HealthCare.gov. You will be able to enroll if you file a federal tax return and don’t have comprehensive, affordable coverage from another source. Depending on your income, you may be able to get subsidies that make buying and using marketplace coverage more affordable. In states that have implemented the Basic Health Program (BHP) (currently New York and Minnesota), you can enroll in BHP if you have an eligible income.

While you are not eligible for federally-funded Medicaid, you may be eligible for state-funded Medicaid or a similar program in some states like Oregon and California.

Can I get help paying for and using health insurance?

Yes! There are two types of subsidies available through the health insurance marketplaces. The first, Advanced Premium Tax Credits (APTCs), helps people and families pay the monthly premiums for their health insurance. When the ACA was enacted, APTCs were only available to people with incomes up to 400% of the Federal Poverty Level (FPL). The law subsequently changed to allow people to get APTCs at higher income levels, based on the percentage of income they needed to pay for insurance. The law that allowed for APTCs at higher income levels is currently scheduled to sunset at the end of 2025, but may be extended again.

It is important to keep in mind that APTCs are a credit against your income taxes that are based on the amount of income you earn. If you underestimate your income when applying for marketplace coverage, you could receive excess APTCs that you will be required to repay when you file your federal income taxes. On the other hand, you may receive a refund if you overestimated your income and didn’t receive all the APTC funds to which you were entitled.

The second type of subsidies are Cost Sharing Reductions (CSRs). CSRs helps people with incomes up to 250% of FPL pay certain “out of pocket” costs of using health care, like deductibles and co-pays. See the next section for important information about selecting a “silver” plan to receive CSRs.

How do I enroll in coverage?

There are a few different ways you can enroll in coverage. You can enroll online at HealthCare.gov or your state’s health insurance marketplace, through an enrollment partner (find one here), by phone, or by mailing in a paper application. Many community organizations like health centers have staff who can help you enroll. You can also find a local organization to help through this webpage.

During the enrollment process, you will need to select a health insurance plan. Marketplace plans are classified as Platinum, Gold, Silver, or Bronze, depending on how the costs of care are divided between you and the plan.

It is important to keep in mind that you must enroll in a silver level plan to receive the CSRs that help to pay for the costs of using your health insurance.

What documents/information do I need to apply?

Typically, you will need information about your household, income, and immigration status. Here is a checklist of the documents you may need.

When can I enroll in coverage?

You can start enrolling on November 1, 2024, through the end of your state’s open enrollment period, usually January 15.

When can I start using my health insurance?

Most people who apply during the annual open enrollment period have to wait until January 1 to begin using their health coverage. However, DACA recipients will be eligible for a “special enrollment period” in 2024 that will allow you to start using health insurance on December 1, 2024 if you enroll by November 15, 2024. If you enroll on November 16, 2024, your coverage may not start until January 1, 2025.

Your selected health insurance company will provide you with an insurance card and information about how to find a doctor in their network.

I have health insurance through my employer. Can I enroll in marketplace coverage instead?

You may be able to get subsidized marketplace coverage depending on the type of coverage your employer offers and how much it costs as a percentage of your income. If you’re in this situation, it’s a good idea to work with a navigator or enrollment assister who is based at a health center or other community organization.

I am self-employed. Can I enroll in the marketplace?

Yes. If you are self-employed, you may apply for marketplace coverage and subsidies (depending on your income).

Is my privacy protected if I apply for coverage on the marketplace?

Yes. Federal laws and regulations require that information you provide can be used only in the operation of the health insurance marketplace. For example, your immigration status or income information may be verified to make sure you are eligible for coverage or subsidies, but not for any other purpose.

For more information, download our Frequently Asked Questions: Affordable Care Act Eligibility for DACA Recipients resource.

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