Note: This content was updated on April 26, 2023 to correct the description of how DACA was created and to reflect the release of proposed regulations to expand health coverage to DACA recipients. On July 17, 2023, a sentence about the proposed April 26th rule was also placed in the Overview.

The Deferred Action for Childhood Arrivals (DACA) program was created to protect eligible young adults who were brought to the U.S. as children from deportation and to provide them with work authorization for temporary, renewable periods. As of December 31, 2022, there were roughly 580,000 active DACA recipients from close to 200 different countries of birth residing all over the U.S. While individuals with DACA status can be authorized to work, they remain ineligible for many federal programs, including health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) health insurance Marketplaces. These restrictions result in higher uninsured rates among DACA recipients, contributing to barriers accessing health care. On April 26, 2023, the Biden Administration published a proposed rule to expand eligibility for health coverage to DACA recipients. Such an eligibility expansion would likely reduce uninsured rates among DACA recipients and, in turn, facilitate access to care and enhance financial protections from medical costs. The future of the DACA program remains uncertain with it subject to pending court rulings.

This brief provides an overview of DACA and who DACA recipients are and provides estimates of health coverage, work status, and income among individuals who meet eligibility criteria for DACA since there are no administrative data on these measures available for DACA recipients. It is based on analysis of data on DACA recipients from the United States Citizen and Immigration Services and analysis of individuals who are likely eligible for DACA using 2022 Current Population Survey Annual Social and Economic Supplement (CPS-ASEC) data. (See methods for more details.)

Overview of DACA

DACA was originally established via executive action in June 2012 to protect certain undocumented immigrants who were brought to the U.S. as children from removal proceedings and receive authorization to work for renewable two-year periods. To be eligible, individuals must have arrived in the U.S. prior to turning 16 and before June 15, 2007; be under the age of 31 as of June 15, 2012 (i.e., under age 41 as of 2022); be currently enrolled in school, have completed high school or its equivalent or be a veteran; and have no lawful status as of June 15, 2012. The program has enabled over 900,000 immigrants to stay in the U.S., go to school, and contribute to the economy through employment.

While DACA protects an individual from removal action for a certain period of time, it does not provide a pathway to U.S. citizenship, and people with DACA status remain ineligible for federally funded health coverage. Individuals with DACA status can be authorized to work, and studies have found that DACA eligibility helps improve physical and mental health, particularly among individuals with low incomes, and can improve the well-being of children of DACA recipients. However, individuals with DACA have limited options for health insurance coverage if they do not have access to employer-sponsored insurance since they remain ineligible for many federal programs, including health coverage through Medicaid, CHIP, and the ACA health insurance Marketplaces. On April 26, 2023, the Biden Administration published a proposed rule to expand eligibility for health coverage to DACA recipients.

The Biden Administration published a final rule in 2022 that would codify DACA largely consistent with its existing eligibility requirements and scope, but it’s implementation is limited subject to court orders. Promulgation of this rule followed a rescission of the program by the Trump Administration in 2017 that was ruled unlawful by the Supreme Court in 2020. While the Biden Administration’s final rule became effective on October 31, 2022, its implementation is limited subject to ongoing litigation. A federal appeals court ruling in early October 2022 found the original 2012 DACA policy to be unlawful and remanded the case back to the district court for further proceedings per the new regulations. Subject to current court orders, as of October 31, 2022, current DACA approvals and work authorizations remain in effect, and the Department of Homeland Security will continue to process DACA renewal requests and related requests for employment authorization. It is also accepting initial DACA and employment authorization requests, however, it cannot process initial requests under the current court orders, so these requests remain on hold.

Characteristics of DACA Recipients

As of December 31, 2022, there were roughly 580,000 active DACA recipients in the U.S. Over one in four (28%) active DACA recipients reside in California, with another 17% living in Texas, 5% in Illinois, 4% in New York, 4% in Florida, and the remaining 42% distributed in other states across the country (Figure 1). DACA recipients are young with the majority under age 36 and over half are female. Seven in ten DACA recipients are single, while nearly three in ten are married. The top countries of birth for active DACA recipients include Mexico (81%), El Salvador (4%), and Guatemala (3%).

Health, Work Status and Income among Individuals Likely Eligible for DACA

Most individuals likely eligible for DACA are healthy and the large majority live in a family with at least one full-time worker (Figure 2). Among individuals who are likely eligible for DACA, estimates find that nearly two-thirds (64%) report their health as excellent or very good, while an additional 28% report their health as good. In comparison, 71% of U.S.-born individuals ages 15-41 report being in excellent or very good health, with an additional 22% reporting being in good health. These findings reflect that younger individuals tend to be healthy. The large majority (84%) of individuals likely eligible for DACA live in a family with at least one full-time worker and over half (54%) of adults are working full-time themselves. Despite high rates of employment, 43% of individuals likely eligible for DACA have incomes below 200% of the federal poverty level (FPL) compared with 26% of U.S.-born individuals in the same age group. This income disparity likely reflects disproportionate employment in lower wage jobs among individuals likely eligible for DACA.

Uninsured Rates for Individuals Likely Eligible for DACA

Individuals likely eligible for DACA are much more likely than U.S.-born individuals in their age group to be uninsured (Figure 3). Overall, 47% of individuals likely eligible for DACA were uninsured, compared to 10% of U.S.-born individuals in their age group. These estimates are higher than other estimates of uninsured rates among DACA recipients based on survey data, likely reflecting differences in the group being analyzed and data source. Although most individuals who are likely eligible for DACA are in a family with a full-time worker, as noted above, they are more likely to be low-income, which likely reflects disproportionate employment in low-wage jobs that are less likely to offer employer-sponsored health insurance. Those without access to affordable coverage through an employer or who cannot afford coverage on the individual market are left with limited options since they are prohibited from enrolling in Medicaid, CHIP, and Marketplace coverage. Under regulations that define lawfully present immigrants for the ACA and guidance issued by the Centers for Medicare and Medicaid Services (CMS), individuals with DACA status are not considered lawfully present for purposes of health coverage eligibility. As such, DACA recipients currently have the same access to health coverage and care as undocumented immigrants. Those who are uninsured are largely reliant on care through community health centers and public health services and can receive treatment for emergency conditions. Some states provide fully-state funded to individuals regardless of immigration status for which DACA recipients can qualify. These states include California and Illinois, which, as noted earlier, are home to large shares of DACA recipients (Table 1).


What are Key Issues Looking Ahead?

Expanding eligibility for federally funded health coverage options to DACA recipients would likely reduce their uninsured rates and improve their access to care. On April 26, 2023, the Biden Administration published a proposed rule to expand eligibility for health coverage to DACA recipients. Under this proposed rule, DACA recipients would be considered lawfully present for purposes of the ACA. As such, those who meet other eligibility requirements would be eligible for ACA coverage, including Marketplace plans and subsidies and Basic Health Plans, and Medicaid and CHIP, if they are pregnant or under age 21 and in a state that has taken up the option to cover lawfully-residing pregnant women and children. Comments on the proposed rule are due by June 23, 2023, and the final rule is planned to take effect on November 1, 2023 to coincide with the open enrollment period. Such an eligibility expansion would likely reduce uninsured rates among DACA recipients and, in turn, facilitate access to care and enhance financial protections from medical costs. Expanding this coverage would increase federal and state costs, but the number of individuals who would be eligible for coverage is limited and not all individuals who are eligible would enroll. The expansion would also offset some state costs in states that provide state-funded coverage to individuals regardless of immigration status for which DACA recipients qualify.

The number of young adults who may benefit from DACA is dwindling over time. Given the requirements to have entered the U.S. prior to June 15, 2007, and to be under the age of 31 as of June 15, 2012, the number of people who could be eligible for DACA is decreasing over time. The American Dream and Promise (DREAM) Act of 2021 would provide a pathway to lawful permanent resident status and eventually citizenship for undocumented immigrants who were brought to the U.S. as children and who meet certain requirements. Different versions of this Act have been proposed in the U.S. Congress since 2001, but have never been passed, and there does not appear to be a current pathway to passage for such legislation.

If the district court reviewing the current case finds the DACA program to be unlawful and no additional legislative or administrative action is taken, individuals will lose their deferred status. Loss of DACA status would result in individuals losing work authorization and potentially being subject to deportation. Employers would likely terminate individuals as they lose work authorization, leading to job losses along with loss of employer-based health coverage. Without access to coverage through an employer, many individuals would likely become uninsured if they were to remain ineligible to enroll in Medicaid or CHIP or to purchase coverage through the Marketplaces. Employment and coverage losses would lead to increased financial pressure and reduced access to care for individuals and their families, who may include citizen children.

Methods
Findings on individuals likely eligible for DACA are based on KFF analysis of Current Population Survey Annual Social and Economic Supplement (CPS-ASEC) 2022 data. For this analysis, undocumented individuals were identified as likely eligible for DACA if they met age, education, and length of residence requirements, including being between ages 15 to 41; being enrolled in school, having completed high school or an equivalent, or being a veteran; and having entered the U.S. prior to 2007 and before the age of 16. Our estimates of the DACA-eligible population differ from administrative data on the DACA population on several demographic characteristics. Most notably, our estimated DACA-eligible population is older and less likely to be female. Since CPS-ASEC data do not directly indicate whether an immigrant is lawfully present, we draw on the methods underlying the 2013 analysis by the State Health Access Data Assistance Center (SHADAC) and the recommendations made by Van Hook et. al. This approach uses the Survey of Income and Program Participation (SIPP) to develop a model that predicts immigration status for each person in the sample; it then applies the model to a second data source, controlling to state-level estimates of total undocumented population as well as the undocumented population in the labor force from the Pew Research Center. For more details on the immigration imputation used in this analysis, see here.

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