OR-Center for Intercultural Organizing

The Center for Intercultural Organizing, along with its partner organizations (noted in the attached letter), opposes the proposed rule amendment to 45 CFR Part 152, concerning eligibility and enrollment in the Pre-Existing Conditions Insurance Plan (PCIP) as well as state insurance exchanges under the Affordable Care Act (ACA) for individuals with Deferred Action for Childhood Arrivals (DACA) status. Individuals given an adjusted status under the DACA policy are eligible to seek a work permit and reside lawfully in the United States for two years on a renewable basis. It seems clear that this fits within the scope of “lawfully present” as understood by federal law; this point is conceded by the wording of this rule change, which frames the exclusion on the basis of deferred action status as an exception to the meaning of “lawfully present” within the ACA, not a refinement of the Department of Health & Human Service’s understanding of that term. It’s also important to note that this rule change does not apply to those with some other kind of deferred action status (such as prosecutorial discretion). Beyond the language of the policy, though, is an even more fundamental problem: the goal of the ACA and accompanying federal regulations is to expand access to care, which can’t be achieved by carving out exclusions to coverage on the basis of immigration status. This rule change will have a profoundly negative impact for the potentially millions of people eligible for DACA, by denying them access to critical health coverage. Further, this change sets an exclusionary precedent for immigrants who might receive other adjustments to their legal status under any future form of executive relief. We urge the Department of Health and Human Services as well as the Center for Medicare & Medicaid Services to reconsider this rule change. Simply put, being eligible for DACA does not fundamentally change an individual’s need for high-quality, affordable health care.