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More than a quarter of DACA recipients are uninsured awaiting the fate of the healthcare rule

More than a quarter of young immigrants protected by the Deferred Action for Childhood Arrivals program lack health insurance and face burdens that prevent them from accessing care, according to new data first shared with NBC News.

A report released Friday by the nonprofit immigrant rights organization National Immigration Law Center, documenting the findings of a recent survey, finds that 27% of DACA recipients reported not being covered by any form of health insurance or other care plan.

The results suggest that of the more than 580,000 young adults without legal status allowed under the Obama-era DACA program to work and study without fear of deportation, it is estimated that nearly 157,000 are uninsured.

The survey was conducted last year among 817 DACA recipients. It was managed by Tom K. Wong, founder and director of the U.S. Immigration Policy Center at the University of California, San Diego, with the help of United We Dream, the nation’s largest immigrant-led youth organization, the Center for American Progress . and the National Immigration Law Center.

An earlier version of the study, conducted in 2021, found the uninsured DACA rate to be 34%. Kica Matos, president of the National Immigration Law Center, attributed the slight decline to “a healthier economic climate”.

“The last survey was conducted while we were still in the midst of the pandemic, so we think economic trends have improved since then… This likely means there are more DACA recipients who are employed and therefore have access to health care” via their employers, she said.

Of DACA recipients who reported having health insurance, 80% said they were covered by an employer or union.

But unlike most in America, if DACA recipients lose their jobs and with it their health insurance, they can’t fall back on federal health insurance programs, which are often cheaper but only available to people with legal immigration status.

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Because ineligibility for federal health insurance contributes to the high uninsured rate of DACA recipients, the Department of Health and Human Services under President Joe Biden proposed a rule that would expand access to health care for them. Research has found that DACA recipients contribute an estimated $6.2 billion each year in federal taxes to fund such programs.

The Biden proposal calls for changes to the definition of “lawful presence” to include DACA recipients for the purposes of Medicaid and Affordable Care Act coverage.

“It gives a lot of us a lot of hope to have affordable access to health care because we often don’t go to a doctor,” said DACA recipient Diana Avila. “The thought of how much it’s going to cost is what drives many of us to not want to go to the doctor.”

The proposed Biden rule is not yet final, meaning DACA recipients’ access to federal health insurance programs is not yet a foregone conclusion.

In response to an email from NBC News, the Centers for Medicare and Medicaid Services, which submitted the proposed rule, stated that, “While we cannot speculate on when the rule will be finalized, please be aware that the proposed rule contains a proposed effective date for all provisions of November 1, 2023.”

The CMS will seek public comment until June 23 on the proposed regulations, “and specifically on the feasibility of this date and whether another effective date should be considered,” it stated.

Avila, 22, was born in Honduras and has lived in Indiana since she was 4 years old, and was 12 when she was diagnosed with DACA in 2012.

Barriers to access to health care

DACA recipients await the fate of the proposed rule at a time when they are three times more likely to be uninsured than the general population, according to last year’s survey.

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DACA has helped many eligible young immigrants access better-paying jobs and educational opportunities, but that hasn’t been the case for all recipients.

“There are still significant disparities in access to health care for this particular population,” Matos said.

According to the survey, DACA recipients reported other barriers to healthcare access:

  • 57% of respondents believed that their immigration status made them ineligible to access care.

  • 51% said they were unaware of affordable care or coverage options available to them.

  • 21% believed that access to health care could negatively impact their immigration status or that of a family member.

Of those surveyed, 71% reported situations in the past where they were unable to pay medical bills or expenses.

In addition, “there are also those memories of families who can’t afford health care and have bills to pay,” Matos added.

Avila remembers growing up in a family of mixed immigration status. That meant she and her eldest sibling had no access to affordable health care, while her younger siblings, who were born in the US, were eligible for care.

As a child, Avila was prone to ear infections, she said. Her mother would use every possible home remedy to avoid doctors and hospitals and avoid prohibitive medical expenses. Her younger brothers, on the other hand, would go to the doctor more often, even for the smallest problems.

When Avila was 18, she suffered a concussion while playing soccer at school and had to see a specialist. She remembered being hesitant to go because she was worried about her and her family’s ability to afford the care.

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“It’s sad to think about that. I considered not being watched and cared for because of the high cost,” she said.

DACA’s Uncertainty – and the Toll on Mental Health

Although DACA has been around for a decade, it has faced legal challenges from the Trump administration and Republican-led states. The program has been closed to new registrants since July 2021 while a lawsuit brought by Texas and other GOP-led states moves through the courts.

To increase the likelihood that DACA will survive legal battles, the Biden administration implemented a rule in October that turned the program into a federal regulation. A federal judge in Texas is expected to rule this year on the legality of the new rule.

“The precarious nature of DACA has brought with it feelings of anxiety, depression, and anxiety about the future of their status because it is so uncertain,” Matos said of DACA recipients.

The new report found that nearly half (48%) of DACA recipients reported experiencing mental or behavioral problems but had not sought help from a mental health professional. The three main barriers were high costs, lack of time and limited access to service providers that could meet their cultural or linguistic needs.

Avila recently graduated from Marian University in Indianapolis with a degree in psychology and works at a non-profit organization that serves immigrants.

Despite the uncertainty surrounding DACA, she plans to go to law school and specialize in immigration law and human rights, hoping a more permanent solution to her immigration status emerges.

“DACA recipients contribute so much to society that it’s time for a change,” Avila said. “A path to citizenship would be the best way to appreciate the work DACA recipients have done since coming to the US”

This article was originally published on NBCNews.com

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