When Camila Bortolleto was 9 years old, her parents brought her from Brazil to the U.S.

Bortolleto’s parents are undocumented, but in 2013 she was approved for the Deferred Action for Childhood Arrivals program, which allowed her to get a job and, with it, job-based health insurance.

Bortolleto, now 36 and living in Connecticut, left her job at a nonprofit in June, which meant losing her health insurance and leaving her with no other options: DACA recipients have been barred from receiving government-funded health insurance.

That changed Friday, when tens of thousands of DACA recipients became able to sign up for health insurance coverage under the Affordable Care Act for the first time.

Camila Bortolleto was approved for the Deferred Action for Childhood Arrivals program in 2013. (Courtesy Camila Bortolleto)

High uninsured rates

DACA was an executive action signed by then-President Barack Obama in June 2012 that protected undocumented immigrants who came to the U.S. as children from deportation and gave them work authorization.

For many, the ability to work also meant access to health insurance.

Without access to government-funded programs, insurance options are extremely limited for Dreamers who didn’t get coverage through their jobs, said Drishti Pillai, director of immigrant health policy at KFF, a nonprofit group that researches health policy issues.

Some turn to state programs for undocumented immigrants, she said. Others may go uninsured and rely on community health clinics that offer free or low-cost care.

The limited options, she said, mean many DACA recipients can’t get quality health insurance, resulting in high uninsured rates.

Legal challenges

In August, Kansas and 18 other states filed a lawsuit to block the ACA rule from taking effect.

The lawsuit says that expanding coverage to DACA recipients will create additional “resource burdens” and harm to taxpayers. It also says it will encourage undocumented immigrants to remain in the U.S. in hopes of receiving health insurance through the ACA.

Arthur Caplan, head of the Division of Medical Ethics at NYU Langone Medical Center in New York City, described the lawsuit as “just more anti-immigration politics.”

“The lawsuit is obnoxious and in many ways counterproductive to public interest,” he said. “It makes sense to get people into health insurance because they’re here and they’re going to show up to the ER if they get sick and you’re going to pay for them at higher prices.”

‘This is my home’

DACA recipients, however, still won’t be able to get coverage through Medicaid or the Children’s Health Insurance Program, which offers free or low-cost insurance for kids and teens, Pillai said.

Dania Sarahi Quezada, 27, a third-year law student at the University of Washington, plans to purchase a health insurance plan Friday.

Quezada, a DACA recipient, said she’s concerned about the lawsuit, but that she’ll continue to seek health care even if the Republican-led states are successful.

“This is my home, and I am going to fight to be allowed to live here,” she said.

Conclusion

The change marks a pivotal moment for the over 535,000 active DACA recipients in the U.S., who have been barred from receiving government-funded health insurance. The limited options have led to high rates of uninsurance among DACA recipients, with a survey published last year finding that about 1 in 4 reported being uninsured.

FAQs

* Who is eligible for the Deferred Action for Childhood Arrivals program?
DACA is an executive action that protects undocumented immigrants who came to the U.S. as children from deportation and gives them work authorization.
* What does the Affordable Care Act (ACA) do?
The ACA is a federal law that provides health insurance to millions of Americans. It allows people to purchase health insurance plans through the HealthCare.gov marketplace.
* What is the lawsuit filed by Kansas and 18 other states against the ACA?
The lawsuit claims that expanding coverage to DACA recipients will create additional “resource burdens” and harm to taxpayers, and that it will encourage undocumented immigrants to remain in the U.S. in hopes of receiving health insurance through the ACA.
* What is the expected impact of the ACA rule change on DACA recipients?
The change is expected to help more than 100,000 people get health insurance, according to a White House fact sheet.