The mission of the Catholic Health Association (CHA) is rooted in the principles of compassion, dignity, and serving the vulnerable while emphasizing the inherent dignity of each person. Catholic hospitals and providers are committed to offering care to all individuals, regardless of their ability to pay or immigration status. This commitment is consistent with Catholic health care’s advocacy for more inclusive and equitable health care coverage for all, and why CHA has been a leading advocate for access to the Affordable Care Act (ACA) marketplace for Deferred Action for Childhood Arrivals (DACA) recipients.

Earlier this year, the U.S. Centers for Medicare and Medicaid Services (CMS) determined DACA recipients’ classification as "lawfully present" individuals makes them eligible to enroll in ACA marketplace plans. During the upcoming open enrollment from November 1, 2024, to January 15, 2025, this rule change takes effect with coverage beginning as soon as this December. This is a significant step toward promoting greater access to affordable health insurance and quality care.

By HHS finalizing the policy to make DACA recipients eligible to access ACA marketplace health coverage, there is a need for outreach and enrollment guidance to maximize the number of people who gain coverage. To support of these efforts, CHA has joined ACA4DACA, a coalition focused on providing resources to help new enrollees understand and navigate available health insurance plans.

DACA is an administrative relief that protects eligible immigrants who came to the United States when they were children. DACA gives undocumented immigrants: 1) protection from deportation, and 2) a work permit. According to the National Immigration Law Center, over the last 10 years, DACA has allowed young immigrants who grew up in the U.S. to seek temporary protection from deportation and to have the ability to work, “transforming the lives of more than 834,000 young people.”

However, one-third of DACA recipients are currently uninsured because they can’t afford the cost of health insurance coverage, which poses a significant barrier to accessing essential health care services. This lack of coverage often forces individuals to rely on costly emergency services, undermining their health and placing an increased burden on the U.S. health care system. CHA recognizes the profound consequences of this coverage gap, which too often can lead to preventable health complications, further worsening the challenges faced by immigrant communities. Access to comprehensive health coverage is not just an individual concern; it embodies a public health issue and reflects our collective responsibility to care for one another.

CHA’s belief that all persons should have equal access to health care is at the forefront of our advocacy efforts to expand health coverage and dismantle barriers to health care access for all immigrants. Legislative efforts focused on this work include:

1. Eliminating the Five-Year Medicaid Waiting Period: Under current law, immigrants must wait five years after becoming lawful permanent residents to access Medicaid. CHA advocates for the elimination of this waiting period, recognizing that timely access to preventive care is essential to upholding human dignity.
2. Comprehensive Immigration Reform: CHA supports comprehensive immigration reform that includes a pathway to citizenship for immigrants, particularly DACA recipients. This reform is aligned with the Church’s call to welcome the stranger and ensure that all individuals can contribute to their communities while receiving the health care they need.
3. Pathways to Citizenship: Beyond health coverage, CHA advocates for the establishment of more pathways to citizenship. Such measures would allow immigrants to secure permanent status, ensuring access to a broader range of services and protections, as emphasized in Catholic teaching on social justice.

While the inclusion of DACA recipients in the ACA marketplace is an important advancement, the work is far from over. Together, we can continue to advocate for equity in health care policies, ensuring that every individual, regardless of their status, has access to the care they need and broader reforms to secure affordable, quality health care for all.