Consumers and consumer assistance workers often have questions about immigration status and eligibility for coverage through Maryland Health Connection. One such status is for individuals in the Deferred Action for Childhood Arrivals (DACA) program, also known as “Dreamers.” Consumer assistance workers will recall that eligibility for coverage through the marketplace is dependent upon U.S. citizenship or “lawfully present immigration status.”  For Medicaid programs in Maryland Health Connection, some statuses also require a lawful presence requirement of five years (“5-year bar”).

Beginning in 2012, the DACA program permitted certain undocumented individuals who came to the U.S. prior to 2017 and before they turned 16 years old to stay in the U.S. and work for temporary renewable periods. Individuals who had DACA status were considered lawfully present except under the Affordable Care Act (ACA); however, in September 2017, President Donald Trump rescinded the DACA program. While a federal court order is requiring the administration to continue processing some renewals of DACA status, some recipients already have begun losing their status. As most DACA recipients are working, many have coverage through their employers. However, if they lose work authorization, in most cases, they also will lose coverage.

Unfortunately, under the ACA, DACA program individuals are not eligible to enroll in Medicaid or the Maryland Children’s Health Program (MCHP). Those individuals also cannot purchase coverage through marketplace plans in Maryland, even coverage without financial assistance. In Maryland, the only option for DACA individuals is to purchase a private health plan outside the marketplace, often at a very high cost.

Consumer assistance workers should be careful how they approach these cases. In many cases, work authorization = lawful presence, so the assumption is that work authorization = Maryland Health Connection eligibility. For dreamers, it’s not as straightforward. Maryland Health Connection checks immigration status through a Verify Lawful Presence (VLP) call to the Department of Homeland Security. The service sometimes can be unavailable or respond after enrollment. Best practice for consumer assistance workers is to pre-screen potential applicants and explain to individuals with DACA status that they are not eligible for coverage through Maryland Health Connection before any application information is entered. One way you can determine status is by reviewing the employment authorization document (I-766), which is annotated with the category “C33” for DACA individuals. 

For more information on DACA, take a look at immigration statuses or the public charge rule.