We need to give Dreamers the opportunities and support they deserve.. In the 2012 SHO, CMS reasoned that because the rationale that DHS offered for adopting the DACA policy did not pertain to eligibility for Medicaid and CHIP, eligibility for these benefits should not be extended as a result of DHS deferring action under DACA. documents in the last year, 125 There may be an effect on the BHP risk pool as a result of this change, as DACA recipients are relatively younger and healthier than the general population, based on USCIS data showing an average age of 29 years. Furthermore, the proposals related to Medicaid and CHIP would impact State governments, but as States do not constitute small entities under the statutory definition, an impact analysis for these provisions is not required under the RFA. 14. The bill would block President Joe Biden's student loan forgiveness program, which promises up to $20,000 in debt relief for low- and middle-income borrowers . better and aid in comparing the online edition to the print edition. The act offers a conditional resident status for Dreamers that protects them from deportation, allows them to work legally in the United States and permits them to travel outside the country. Under our current Medicaid regulations, a qualified non-citizen is defined at 42 CFR 435.4 and includes an individual described in 8 U.S.C. Dreamers' lives were thrown into chaos when the Trump Administration tried to terminate the DACA program without obeying the law. SHO) #12002: Individuals with Deferred Action for Childhood Arrivals We believe that few, if any, insurance companies underwriting comprehensive health insurance policies (in contrast, for example, to travel insurance policies or dental discount policies) fall below these size thresholds. As required by OMB Circular A4 (available at Biden moves to expand health care coverage for "Dreamers" in DACA 37. The DACA final rule takes effect on Oct. 31, 2022, to the extent permitted by current court orders. L. 1044), and Executive Order 13132 on Federalism (August 4, 1999). The proposed changes to 42 CFR 435.4 and 457.320(c) would no longer exclude DACA recipients from the definition of lawfully present used to determine eligibility for Medicaid and CHIP under section 214 of CHIPRA and treat DACA recipients the same as other recipients of deferred action. 8. [21] Sec. 3. These costs are projected to increase annually as the price and use of services increase. 45. Senator Dick Durbin: Passing the Dream Act is a matter of simple American fairness and justice that would provide Dreamers the sense of stability they deserve and a path to lawful permanent residence.. Therefore, to calculate costs, we used data from USCIS to determine the average age of a DACA recipient, which is 29, and we used PTC data to determine the average PTC for a 29-year-old, which is estimated to be $289 per month, and multiplied this by 12 months per year and by the projected number of enrollees per year to arrive at annual costs. With a potential increase in number of enrollees, there may be an increase in Federal payments to a State's BHP trust fund. Assuming an average reading speed of 250 words per minute, we estimate that it would take approximately 1.4 hours for each individual to review the entire proposed rule (approximately 21,000 words/250 words per minute = 84 minutes). 44. The Demographic and Economic Impacts of DACA Recipients: Fall 2021 They are not quite citizens and DACA itself does not create a path to citizenship, but they are protected from deportation and allowed to live and work and raise families in the United States. The proposed changes to 45 CFR 152.2 and 155.20 would make DACA recipients eligible to enroll in a QHP through an Exchange, and for APTC and CSRs, if otherwise eligible. The proposed changes to 42 CFR 600.5 would no longer exclude DACA recipients from the definition of lawfully present used to determine eligibility for a BHP in those States that elect to operate the program, if otherwise eligible. Having sizeable groups of people who live, work, go to school and make their home in the U.S. but cannot access vital health benefits is bad for everyone, Michener said in an email. DACA recipients with work authorization may qualify for Job Corps, a no-cost education and vocational training program administered by the U.S. Department of Labor, which helps individuals ages 16 . In June 2012, DHS issued the memorandum Exercising Prosecutorial Discretion with Respect to Individuals Who Came to the United States as Children, establishing the DACA policy. It is perhaps ironic that the attorneys general who have brought the issue to federal courts are creating a moment of truth, Mr. Appleby says. a legal work permit issued by the federal government. Any doctors visits due, everything that I possibly can, because prior to todays announcement, I really couldnt afford to keep it any more than the year I have had it.. Although the intent of this proposed rule is to make conforming changes to the definition of lawfully present across all CMS insurance affordability programs, we recognize the underlying statutory authorities and respective regulations contain some differences and apply to different populations. Please visit ourmembership pageto learn how you can invest in our work by subscribing to the magazine or making a donation. (12) Has been granted withholding of removal under the Convention Against Torture; (13) Has a pending or approved petition for Special Immigrant Juvenile classification as described in 8 U.S.C. of this proposed rule, and the costs to consumers as a result of increased information collections associated with this proposal, which include applying for BHP and submitting additional information to verify their lawful presence, if necessary, are discussed in section IV.C.4. (2010). What Should Employers Do with Their DACA Employees? Thus, the proposed revision to the definition would help to streamline and expedite verification of status for individuals who have been granted an EAD under this regulatory provision. What is the power state of one DACA program? In 2014, CMS issued regulations establishing the framework governing a BHP, which also adopted the definition of lawfully present at 45 CFR 152.2, thereby aligning the definition of lawfully present for a BHP with Exchanges, Medicaid and CHIP. DACA recipients will soon be eligible for government-funded health By our estimate, these requirements do not impose substantial direct costs on States. J. Kevin Appleby acknowledges that the U.S. Conference of Catholic Bishops has been a consistent supporter of immigrants and immigration reform, but he says it is time for the bishops to consider a more high-profile gesture for one adjacent issue in particular. 3. 1641(b) or (c). 2023 Update on Key Federal Immigration Policies and Implications for Problem Solvers Caucus Announces Principles to Resolve Impasse on DACA We do not believe that this threshold will be reached by the requirements in this proposed rule. In light of DHS's clarifications, HHS sees no persuasive reasons to treat DACA recipients differently from other noncitizens who have been granted deferred action. (2012) CC, Title II, sec. Impacts on the Economy, Communities, and States 6. In this rule, we propose conforming amendments to the BHP regulations to remove the current cross-reference to 45 CFR 152.2 in the definition of lawfully present at 42 CFR 600.5. There is currently one State (Washington) with an approved section 1332 waiver that includes a waiver of the lawfully present framework to the extent necessary to permit all State residents, regardless of immigration status, to enroll in a QHP and Qualified Dental Plan (QDP) through the State's Exchange, as well as to apply for State subsidies to defray the costs of enrolling in such coverage. 1503 & 1507. roughly 34 percent of DACA recipients were uninsured. Extending health benefits to these individuals is consistent with those fundamental goals of DACA. Learn more here. Therefore, we are using estimates in this RIA to reflect that nearly all applicants would apply using the electronic application. Submit a formal comment. 56. Since 2010, CMS has interpreted lawfully residing to mean individuals who are lawfully present in the United States and who are residents of the State in which they are applying under the State's Medicaid or CHIP residency rules. Additionally, the small number of individuals included in the proposed eligibility categories would benefit from increased access to health coverage and insurance affordability programs. 10. Deferred Action for Childhood Arrivals (DACA): An Overview That number is down from previous years. CMS is not proposing a change from its current policy described in the 2010 SHO regarding individuals who are lawfully present in American Samoa. 59. According to Institute on Taxation and Economic Policy, undocumented immigrants contribute an estimated $11.74 billion to state and local economies each year. 1641(b) and (c), as well as additional categories of noncitizens that Medicaid agencies are required to cover as a result of subsequently enacted. This proposed rule would update the definition of lawfully present in our regulations. Additionally, the CHIPRA 214 option gives States the option to elect to cover lawfully residing pregnant individuals and children in their Medicaid and/or CHIP programs. Households containing DACA recipients have $24 billion in after-tax spending power. 1101 of the Patient Protection and Affordable Care Act (Pub. 1806(e)(6). Similarly, a rule consisting only of the changes proposed in section II.D.3. As such, there may be a slight effect on the Exchange or BHP risk pools as a result of this proposed change, discussed further in the Regulatory Impact Analysis in section VI.C. Financial burden pertaining to BHP and State Exchange information collection changes is covered entirely by States, as discussed further in sections IV.C.2. this helps us promote a safe and accountable online community, and allows us to update you when other commenters reply to your posts. United States, See Besides the initial shock OK, the next five to 10 years after college are going to look a lot different from what I expected I was pretty disheartened that this was an issue because, as a DACA recipient, you have this work authorization and you think this solves a lot of my problems, Sara says. The DACA program was started in 2012 to allow undocumented children who came to the U.S. as immigrants a chance to stay and work in the country for two years. While a 2021 survey of DACA recipients found that DACA may facilitate access to health insurance through employer-based plans, 34 percent of DACA recipient respondents reported that they were not Combined with reviewers for the Exchanges, this results in an estimate of 191 reviewers. Please see section II.D.3. 46. Accordingly, in this proposed rule, when we refer to the regulatory definition of lawfully present used to determine whether a consumer is eligible to enroll in a QHP through an Exchange, we also are referring to the regulatory definition used to determine whether a consumer is eligible for APTC and CSRs. All comments are considered public and will be posted online once the Health and Human Services Department has reviewed them. This estimate may overstate the actual number of small health insurance issuers that may be affected, since over 76 percent of these small issuers belong to larger holding groups, and many, if not all, of these small companies are likely to have non-health lines of business that will result in their revenues exceeding $44.5 million. What Is DACA? Everything You Need to Know - Boundless L. 111152, 124 Stat 1029). Criminality, National Security . L. 106554, enacted December 21, 2000), referred to hereinafter as the LIFE Act Amendments. As previously described, CMS' authority to remove the exclusion treating recipients of deferred action under the DACA policy differently from other noncitizens with deferred action under the definition of lawfully present for purposes of eligibility for insurance affordability programs is well-supported in law and practice and should be upheld in any legal challenge. DHS also stated that HHS and other agencies whose statutes independently link eligibility for benefits to lawful presence may have the authority to construe such language for purposes of those statutory provisions (87 FR 53152). The Consolidated Appropriations Act, 2021 added individuals who lawfully reside in the United States in accordance with COFA to the definition of qualified alien under new paragraph (8) of 8 U.S.C. But despite the courts conservative majority, its not an automatic assumption that theyre gonna strike it down, Mr. Appleby says. Secretary, Department of Health and Human Services. These markup elements allow the user to see how the document follows the We also note that this proposed rule would not provide any noncitizen relief or protection from removal, or convey any immigration status or other authority for a noncitizen to remain in the United States under existing immigration laws or to become eligible for any immigration benefit available under the U.S. Department of Homeland Security (DHS)'s or Department of Justice's purview. Tracking DACA Recipients' Access to Health Care. However, COFA migrants would generally be considered lawfully present under paragraph (2) of the proposed lawfully present definition at 45 CFR 152.2 regarding nonimmigrants, as they are considered lawfully present under existing regulations in paragraph (2) of the defintion at 45 CFR 152.2 today, and thus would continue to be eligible for Exchange coverage in a QHP, APTC, CSRs, and BHP, if they meet all other eligibility requirements for those programs. }i(?|d(8x=y L. 111148, 124 Stat. endstream endobj startxref DACA recipients have been called Dreamers because of the name of proposed legislation that hopes to regularize the lives of people registered in DACA and now millions of other U.S. residents brought into the United States under the same circumstancesthe Development, Relief, and Education for Alien Minors Act, known colloquially as the Dream Act. In aggregate, we estimate a one-time burden of 3,900 hours (39 States America is a country of immigrants, and we should legislate accordingly., Sen. Dick Durbin: I have never understood the opposition to DACA and the Dreamers. Dizioli, Allan and Pinheiro, Roberto. 18041, HHS has discretion to determine the best legal interpretations of these terms for purposes of administering its programs. Other Impacts on the Federal Government 9. We propose several modifications to the definition of lawfully present currently articulated at 45 CFR 152.2 and described in the SHO letters for Medicaid and CHIP. [41] These tools are designed to help you understand the official document 2, Division FF, Title V, Subtitle D, Sec. Likewise, CMS intends that if one provision of the changes to the definition of lawfully present is struck down, that other provisions within that regulation be severable to the extent possible. The posting also stated that applicants have to pass a Public trust background investigation and obtain a U.S. Federal government client badge. of this proposed rule and the costs to consumers as a result of increased information collections associated with this proposal, which include applying for Exchange coverage and submitting additional information to verify their lawful presence, if necessary, are discussed in section IV.C.4. Using the per-application processing burden of 10 minutes (0.17 hours) per application at a rate of $46.70 per hour, this results in a burden of 15,677 hours, or $732,135, for State Exchanges and 13,903 hours, or $649,251, for the Federal Government. See Pending such comments, and to ensure alignment across CMS programs, we propose that the Exchange regulations at 45 CFR 155.20 define qualified noncitizen by including a citation to the Medicaid regulations at 42 CFR 435.4, rather than to PRWORA. As discussed in section VI.C. 36B(e)(2). We are proposing this modification to the regulatory text to include all noncitizens who have been granted an Employment Authorization . Than a result of these most recent rulings, existing DACA recipients retain their grant off DACA and are allowed into apply for (and receive) renewal, but the government cannot grant new DACA applications. documents in the last year, by the Food and Drug Administration As discussed previously, the changes proposed to the definition of lawfully present would impact eligibility for Medicaid and CHIP in States that have elected the CHIPRA 214 option. We estimated about 7,000 pregnant individuals would enroll in 2024, declining to about 6,000 by 2028. Executive Order 13132 establishes certain requirements that an agency If resource use remains the same but different entities in society pay for them, then the estimated effects would instead be transfers. [29] of this proposed rule. The proposed change to no longer exclude DACA recipients from CMS definitions of lawfully present aligns with both the longstanding DHS definition of lawful presence under 8 CFR 1.3 and DHS's explanation of this definition in the DHS DACA Final Rule. Further, there are some scenarios where individuals need not have an approved visa petition at all, such as individuals applying for adjustment of status under the Cuban Adjustment Act. We have examined the impacts of this rule as required by Executive Order 12866 on Regulatory Planning and Review (September 30, 1993), Executive Order 13563 on Improving Regulation and Regulatory Review (January 18, 2011), the Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. Since 1996, when the Department of Justice's Immigration and Naturalization Service issued an interim final rule defining the term lawfully present as used in the recently enacted PRWORA, Federal agencies have considered deferred action recipients to be lawfully present for purposes of certain Social Security benefits (see We seek public comment on our consideration of modifying the definition of qualified noncitizen in 42 CFR 435.4 in this manner.