July 16, 2024

Castro, Booker, 86 Democrats Push for Outreach to Help DACA Recipients Apply for ACA Coverage

WASHINGTON — Today, Congressman Joaquin Castro (TX-20) and Senator Cory Booker (N.J.) led 86 of their colleagues in the House and Senate in a letter urging the Department of Health and Human Services (HHS) to expand investment in outreach and enrollment assistance to Deferred Action for Childhood Arrivals (DACA) recipients ahead of the upcoming November open enrollment period for Affordable Care Act (ACA) health insurance.

Congressman Castro and Senator Booker have been longtime leaders in efforts to expand healthcare access for immigrant communities. To read more about their successful push to secure the May 2024 rule that expanded access to ACA coverage for DACA recipients, click here and here.

“Starting on November 1, 2024, DACA recipients will be able to enroll in health coverage through Healthcare.gov or their state-based marketplace. While this timeline aligns with the annual open enrollment period, DACA recipients will be simultaneously eligible for a special enrollment period, allowing them to start using health insurance benefits by December 1, 2024 if enrolled by November 15, 2024. Given this unique and time-sensitive opportunity, it is imperative that DACA recipients know of this opportunity, are informed about their eligibility, and are able to navigate the registration process so that they can take full advantage of their new access to medical care,” the members wrote in today’s letter.

“To accomplish this goal, HHS should invest resources into paid media outreach, funding to community organizations to disseminate information, and HHS staff time into a targeted outreach program for newly eligible DACA recipients. Given that most DACA recipients are under 30, and identified as a “hard to reach” population, HHS must ensure information is not only available but actively and prominently disseminated. With a plurality of DACA recipients preferring to get information about health coverage from a government website, HHS needs to ensure this information is not only available, but actively publicized and promoted to them,” the members continued.

Background:

Texas and New Jersey are among the states with the highest number of DACA recipients, with 88,250 DACA recipients in Texas and 12,810 DACA recipients in New Jersey as of March 2024. Recent survey data indicates that DACA recipients are nearly three times as likely to be uninsured as the general population in the United States, with more than a quarter (27%) reporting that they do not have any kind of health insurance. The Center for Medicare and Medicaid Services estimates that the Biden administration’s rule could lead to 100,000 previously uninsured DACA recipients enrolling in health care coverage through the ACA marketplace or a Basic Health Program.

The signers of today’s letter included:

Representatives Joaquin Castro (TX-20), Adam Smith (WA-09), Andrea Salinas (OR-06), Andy Kim (NJ-03), Barbara Lee (CA-12), Bennie G. Thompson (MS-02), Bill Foster (IL-11), Bill Pascrell, Jr. (NJ-09), Bonnie Watson Coleman (NJ-12), Brad Sherman (CA-32), Brad Schneider (IL-10), Cori Bush (MO-01), Dan Goldman (NY-10), Darren Soto (FL-09), Debbie Wasserman Schultz (FL-25), Delia C. Ramirez (IL-03), Diana DeGette (CO-01), Dina Titus (NV-01), Eleanor Holmes Norton (DC), Emanuel Cleaver, II (MO-05), Eric Swalwell (CA-14), Frederica S. Wilson (FL-24), Gerald E. Connolly (VA-11), Grace F. Napolitano (CA-31), Grace Meng (NY-06), Greg Casar (TX-35), Greg Stanton (AZ-04), Haley M. Stevens (MI-11), Henry C. "Hank" Johnson, Jr. (GA-04), J. Luis Correa (CA-46), Jamaal Bowman, Ed.D. (NY-16), James P. McGovern (MA-02), Jamie Raskin (MD-08), Jan Schakowsky (IL-09), Jerrold Nadler (NY-12), Jesús G. "Chuy" García (IL-04), Jimmy Gomez (CA-34), Jonathan L. Jackson (IL-01), Juan Vargas (CA-51), Judy Chu (CA-28), Julia Brownley (CA-26), Kathy Castor (FL-14), Katie Porter (CA-47), Linda T. Sánchez (CA-38), Lloyd Doggett (TX-37), Lori Trahan (MA-03), Mark Pocan (WI-02), Mark Takano (CA-39), Maxwell Alejandro Frost (FL-10), Melanie Stansbury (NM-01), Mike Quigley (IL-05), Nanette Diaz Barragán (CA-44), Nikema Williams (GA-05), Norma J. Torres (CA-35), Nydia M. Velázquez (NY-07), Pete Aguilar (CA-33), Pramila Jayapal (WA-07), Raúl M. Grijalva (AZ-07), Raul Ruiz (CA-25), Ritchie Torres (NY-15), Robert Garcia (CA-42), Salud Carbajal (CA-24), Sara Jacobs (CA-51), Sean Casten (IL-06), Seth Magaziner (RI-02), Sheila Cherfilus-McCormick (FL-20), Shri Thanedar (MI-13), Suzanne Bonamici (OR-01), Sylvia R. Garcia (TX-29), Teresa Leger Fernández (NM-03), Tony Cárdenas (CA-29), Veronica Escobar (TX-16), and Yvette D. Clarke (NY-09).

Senators Cory Booker (NJ), Alex Padilla (CA), Ben Ray Luján (NM), Benjamin L. Cardin (MD), Catherine Cortez Masto (NV), Jacky Rosen (NV), John Hickenlooper (CO), Laphonza Butler (CA), Martin Heinrich (NM), Mazie K. Hirono (HI), Michael F. Bennet (CO), Patty Murray (WA), Peter Welch (VT), Richard J. Durbin (IL), and Tammy Duckworth (IL),

The full text of today’s letter can be viewed here and below.

Dear Secretary Becerra,

We write to request that the Department of Health and Human Services (HHS) allocate adequate resources for outreach to and enrollment assistance for DACA recipients newly eligible for Affordable Care Act (ACA) health insurance. We deeply appreciate the recent finalization of the regulation that expanded eligibility to this population. It is an essential step towards health equity and improving the well-being of our communities. For this expansion to be successful, HHS must ensure that every newly eligible individual is fully informed and supported during the enrollment process.

Starting on November 1, 2024, DACA recipients will be able to enroll in health coverage through Healthcare.gov or their state-based marketplace. While this timeline aligns with the annual open enrollment period, DACA recipients will be simultaneously eligible for a special enrollment period, allowing them to start using health insurance benefits by December 1, 2024 if enrolled by November 15, 2024. Given this unique and time-sensitive opportunity, it is imperative that DACA recipients know of this opportunity, are informed about their eligibility, and are able to navigate the registration process so that they can take full advantage of their new access to medical care.

To accomplish this goal, HHS should invest resources into paid media outreach, funding to community organizations to disseminate information, and HHS staff time into a targeted outreach program for newly eligible DACA recipients. Given that most DACA recipients are under 30, and identified as a “hard to reach” population, HHS must ensure information is not only available but actively and prominently disseminated. With a plurality of DACA recipients preferring to get information about health coverage from a government website, HHS needs to ensure this information is not only available, but actively publicized and promoted to them.

It is equally important that anyone assisting in outreach and enrollment is well trained given the newness of this policy. Call center employees should receive training on the program and newly eligible population. Individuals providing enrollment assistance, including navigators, certified application counselors, brokers and agents, should also receive updated training. HHS should proactively take steps to prevent any attempts at scams or fraud of newly eligible DACA recipients, given reports of unauthorized plan switching, as well as scammers targeting DACA recipients, both online and through other methods. Content should include options for enrollment, the Special Enrollment Period, and the fact that individuals earning below the poverty line but ineligible for Medicaid because of their immigration status may still enroll in subsidized marketplace plans. 

We also urge you to minimize the chances of DACA recipients encountering barriers to enrollment in healthcare.gov or marketplace coverage. We are well aware of the issues that healthcare.gov had during its 2013 launch and that immigrants continue to face challenges verifying their identity or status. HHS should allocate adequate time to test all technical updates to its eligibility system, work with the Department of Homeland Security to proactively address any potential verification errors, and provide technical assistance to state-based exchanges. 

For that reason, we asked that you address the following questions:

  1. How do you plan to inform and support newly eligible individuals of and during the enrollment process, following the recent finalization of the regulation expanding eligibility to this population?
  2. What steps will HHS take to ensure that DACA recipients are aware of the special enrollment period, allowing them to secure health insurance benefits by December 1, 2024, if enrolled by November 15, 2024?
  3. What resources will you allocate for paid media outreach, funding to community organizations, and targeted outreach programs for newly-eligible DACA recipients?
  4. Considering that most DACA recipients are under 30 and identified as a “hard to reach” population, how will you ensure that information is actively and prominently disseminated to that group?
  5. What proactive measures will be taken to prevent scams or fraud targeting DACA recipients during the enrollment process?
  6. How do you plan to minimize barriers to enrollment in healthcare.gov or marketplace coverage, given past challenges and ongoing issues with identity verification?

Thank you for your continued support and collaboration on this important issue and we look forward to working with you to ensure DACA recipients have access to their health insurance benefits.