DREAMers Access to Public Health Insurance Is Threatened
Who are DREAMers?
DREAMers are undocumented immigrants who were brought to the United States as children and have grown up in the country. Many DREAMers have benefited from the Deferred Action for Childhood Arrivals (DACA) program, which offers temporary protection from deportation and work authorization(2). This program holds that these people are not responsible for the decisions of their parents or guardians who brought them into the country while they were still children.
DREAMers have and continue to play a vital role in the country. They contribute to the U.S. economy, working in essential sectors such as healthcare, technology, education, and agriculture. Many DREAMers are highly educated and pursue degrees in fields like engineering, science, and medicine, further enriching the nation’s intellectual and professional landscape. While many of these people are working and can get insurance through their employer, we see a high uninsured rate among this population(2).
Having grown up in the U.S., they identify strongly with American values and culture, actively contributing to their communities. Public support for DREAMers remains high, as many Americans recognize their potential and their positive impact on society(2). As such, DREAMers are seen as an integral part of the nation's future, contributing meaningfully to the workforce, economy, and social fabric.
DREAMers Current Access to Public Health Insurance
In December 2024, a federal judge temporarily blocked a Biden administration policy that would have allowed DREAMers to access health insurance through the Affordable Care Act’s public marketplace in 19 states. The ruling, issued by Judge Daniel Traynor of North Dakota, follows a lawsuit filed by Republican state attorneys general, who argued that the policy could encourage illegal immigration and lead to increased costs for states. Traynor agreed, stating that subsidized health coverage might create financial risks for states. Multiple states, including Kansas, North Dakota, and others, supported the lawsuit, all of which argue that the federal government exceeded its authority(2).
Advocates for Dreamers, such as the National Immigration Law Center, criticized the ruling, and pointed out that many Dreamers have been waiting for access to vital health coverage. The legal fight is ongoing, and further legal challenges and rulings are sure to follow with the recent inauguration of President Trump.
The Future for DREAMers and Their Access to the ACA
In response to potential policy changes under the incoming administration, Oregon and 13 other states are utilizing their state attorney generals to take legal action to protect healthcare access for Dreamers(4). These states are defending a regulation under the Affordable Care Act (ACA) that allows individuals protected by Deferred Action for Childhood Arrivals (DACA) to purchase insurance through ACA exchanges. While some states have seen a halt in the policy following the legal challenge by Judge Traynor, Oregon and others have continued its enforcement. The 14 states argue that the rule benefits Dreamers, strengthens healthcare markets, and helps stabilize costs by diversifying the risk pool. Attorney General Anthony G. Brown of Maryland emphasized the importance of ensuring Dreamers can access affordable healthcare, regardless of their immigration status. She said, "Dreamers should not be denied the opportunity to purchase high-quality, affordable health care coverage because of a decision their loved ones made for them when they came to the U.S."
President Trump has not made his stance on DACA or their access to the ACA entirely clear. See our previous post about Trump and the State of the ACA. During his first term, Donald Trump attempted to eliminate the DACA program, but he since seemed to lighten his stance towards the program. It is telling that the 19 states challenging the Biden policy allowing DREAMers to purchase ACA healthcare coverage are all republican controlled states.
In many states, the message toward DREAMers is inconsistent. While the future of access to the ACA remains uncertain, strategists are telling people to get the care they need now(2). The legal battles will likely play out over the coming months and years; while many DREAMers who require access to critical healthcare are caught in the middle.