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A new rule impacting Marketplace eligibility for DACA Recipients and certain other noncitizens



Health Insurance Marketplace

June 26, 2024

HHS Finalizes Policies to Increase Access to Health Coverage for DACA Recipients

The Centers for Medicare & Medicaid Services (CMS) recently published a final rule to modify the definition of “lawfully present” applicable to eligibility for enrollment in a Qualified Health Plan (QHP) through the Marketplace and a Basic Health Program (BHP) to *no longer exclude Deferred Action for Childhood Arrivals (DACA) recipients from that definition. *The final rule also now requires such programs to treat DACA recipients the same as all other recipients of deferred action.

_Effective November 1, 2024_, this rule allows DACA recipients who meet all other eligibility requirements to enroll in:


* a QHP through the Marketplace with financial assistance such as advance payments of the premium tax credit and cost sharing reductions; or
* a BHP.

*CMS estimates that this rule could lead to 100,000 previously uninsured DACA recipients newly enrolling in health coverage through a Marketplace plan or a BHP. *As a result of this rule, you may see an increase in consumers who need your help enrolling in Marketplace coverage later this year.


* For more information about this new rule and how it may affect your consumers, visit the fact sheet [ https://www.cms.gov/newsroom/fact-sheets/hhs-final-rule-clarifying-eligibility-deferred-action-childhood-arrivals-daca-recipients-and-certain ] or final rule [ https://www.federalregister.gov/public-inspection/2024-09661/clarifying-the-eligibility-of-deferred-action-for-childhood-arrivals-recipients-and-certain-other ].
* You may also find this presentation [ https://www.cms.gov/marketplace/technical-assistance-resources/immigrant-eligibility-marketplace-medicaid-chip.pdf ] helpful, which reviews immigrant eligibility for Marketplace or Medicaid coverage, how to resolve Citizenship/Immigration common data matching issues, and complex scenarios you may encounter.
* *Stay tuned for an assister webinar that will dive deeper into this new rule. You’ll receive an email when registration is open.*

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*"Have questions? "*"Certified Application Counselors (CACs) should contact the CAC mailbox at CACQuestions@cms.hhs.gov, EAPs should contact ""EAPQuestions@cms.hhs.gov" <EAPQuestions@cms.hhs.gov>"_,_ and Navigators should reach out to their Project Officer."




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