On Apr. 24, CMS reported HHS issued proposal to expand coverage.
HHS via CMS issued notice of proposed rulemaking (NPRM) to expand access to health care by reducing barriers for Deferred action for childhood arrivals (DACA) recipients.
Follows White House announcement of plan to expand health care to DACA, #169436.
If approved, would apply to the health insurance marketplaces, the Basic Health Program, and some Medicaid and Children’s health insurance programs (CHIP).
Proposed Rulemaking
Would remove current exclusion that treats DACA recipients differently from other individuals with deferred action who would otherwise be eligible for coverage.
Amend definition of lawfully present re DACA recipients for purposes of Medicaid, CHIP.
Would extend Medicaid and CHIP coverage to children and pregnant women in states that have elected CHIPRA 214 option for children and/or pregnant individuals.
Also, the Basic Health Program and Affordable care act (ACA) marketplace coverage.
Technical changes to the definition of lawfully present would benefit consumers by enabling CMS and states to administer their programs more efficiently for noncitizens.
Recipients would need to meet all other eligibility requirements to qualify for coverage.
Additionally, recipients would be eligible for financial assistance through marketplace.
Such as advance payments of the premium tax credit and cost-sharing reductions.
Effectiveness
NPRM has a proposed effective date for all proposed provisions of Nov. 1, 2023.
Recipients would qualify for a special enrollment period to select a qualified health plan through a marketplace during the 60 days following the effective date of the final rule.
Consultation
To be assured consideration, comments must be received by Jun. 23, 2023.
Jun. 2023 CT AG Coalition Comment Letter
On Jun. 26, 2023, CT AG reported coalition of 19 States issued a comment letter supporting new proposed rule to expand Medicaid and ACA eligibility for Dreamers.
Coalition urged Department to finalize regulations expanding access to DACA recipients
Rule not only valid exercise of regulatory authority, would also increase health and wellbeing among vulnerable population, allow recipients to better support themselves.
May 3, 2024 CMS Final Rule
On May 3, 2024, CMS reported final rule expanding health care for DACA recipients.
Also published related fact sheet on rule that ensures health coverage to uninsured.
Modifies definition of lawfully present for DACA recipients to be eligible for enrollment in qualified health plan through the Marketplace and or through basic health program.
May also qualify for advance payments of the premium tax credit and cost-sharing reductions to reduce the cost of Marketplace coverage, depending on income level.
ACA recipients and other newly eligible individuals will have special enrollment period to select Marketplace health plan during 60 days following the rule’s effective date.
Also updates the definition of qualified noncitizen for Medicaid and CHIP programs.
All provisions of the DACA health care final rule will be effective on Nov. 1, 2024.
May 8, 2024 CMS Fed Reg Final Rule
On May 8, 2024, CMS published final rule in federal register, effective Nov. 1, 2024.
CMS is finalizing the Exchange and BHP policies as discussed in the associated sections of this final rule, and not finalizing the Medicaid and CHIP proposals at this time.
CMS not finalizing lawfully present or lawfully residing definition for Medicaid, CHIP.
