A coalition of 121 Democratic members of Congress, spearheaded by U.S. Senators Cory Booker (D-NJ) and Mazie Hirono (D-HI), along with U.S. Representatives Joaquin Castro (D-TX-20) and Pramila Jayapal (D-WA-07), formally expressed strong opposition to a proposed rule change by the Department of Health and Human Services (HHS).
In a letter addressed to HHS Secretary Robert F. Kennedy, Jr., the lawmakers condemned the department’s proposal to reverse the Affordable Care Act (ACA) Marketplace eligibility for recipients of the Deferred Action for Childhood Arrivals (DACA) program.
They argue this reversal would drastically curtail access to essential, affordable health coverage for hundreds of thousands of individuals often referred to as Dreamers.
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The lawmakers assert that the original intent of the ACA was clear: “The ACA makes all lawfully present immigrants eligible for marketplace coverage.”
They point out that the initial regulatory definition of “lawfully present immigrants” established by the Center for Medicare and Medicaid Services (CMS) in 2010 included those with deferred action status, aligning with existing federal policies for Social Security and REAL ID Act driver’s licenses.
However, the letter highlights a 2012 change where CMS, “without any statutory justification,” specifically excluded DACA recipients. “We believe CMS made the wrong decision, arbitrarily excluding hundreds of thousands of immigrant youth from health coverage despite Congress’s intent in passing the ACA to widely expand access to health care,” the lawmakers wrote.
This exclusion was corrected in 2024 when HHS finalized a rule granting ACA Marketplace and subsidy eligibility to DACA recipients.
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The lawmakers emphasized the positive impact of this recent rule, noting that “Prior to this rule, DACA recipients were nearly five times more likely to be uninsured compared to their U.S. born peers.”
The current proposal under Secretary Kennedy, they warn, “would reverse course and tear health coverage away from DACA recipients who have only had eligibility for less than a year.”
Interestingly, the lawmakers referenced President Trump’s own statements regarding Dreamers. They cited his remarks from December 2024, where he acknowledged the need for Congress to “do something about the Dreamers, because these are people that have been brought here at a very young age…”
Concluding their appeal, the lawmakers stated, “We agree with President Trump that Congress must pass the DREAM Act to create a pathway to citizenship for DACA recipients. In the meantime, CMS must not enact this proposed rule. Removing ACA eligibility undermines the law’s purpose, contravenes President Trump’s priorities, and jeopardizes the health and stability of hundreds of thousands of immigrant families.”
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