Attorney General Ellison takes action to protect Affordable Care Act access for DACA recipients

With incoming Trump administration expected to withdraw support, Minnesota and 13 others intervene to defend access to healthcare from court challenge

January 15, 2025 (SAINT PAUL) – Attorney General Ellison today announced that he and 13 other states are joining together to defend health insurance access for Dreamers from court challenges.

The motion to intervene comes as the incoming Trump Administration is expected to halt federal efforts to legally defend the U.S. Department of Health and Human Services (HHS) and Center for Medicaid and Medicare Services’ (CMS) Final Rule granting access to Affordable Care Act (ACA) exchanges for Deferred Action for Childhood Arrivals (DACA) recipients from a legal challenge brought by a coalition of States led by the State of Kansas.

“Dreamers have given so much to their communities and our country, from starting families to founding businesses and creating jobs to serving in uniform,” said Attorney General Ellison. “Allowing Dreamers to purchase health insurance through the Affordable Care Act is a common-sense measure that has been working well. It is deeply disappointing that some are playing politics with the health of our neighbors, and I will not stand for it. Today, I am joining with other attorneys general to defend Dreamers’ access to health care and their ability to live with dignity, safety, and respect.”

Established in 2012, DACA enables certain young people, who came to the United States as children and have lived here continuously since 2007, to avoid immediate fear of deportation for revocable two-year periods. Separate regulations establish that individuals who have received grants of deferred action may work lawfully in the country.

Last year, the Biden Administration issued a regulation that expands healthcare access to DACA recipients – commonly referred to as Dreamers – by making them eligible to purchase health insurance through ACA exchanges. Other states sued HHS and CMS in the U.S. District Court for the District of North Dakota in August 2024 and asked the court to delay implementation of the Final Rule, pending judicial review. The district court prevented implementation in some states, but left the Final Rule in place in most states—including Minnesota.

The Final Rule, Clarifying the Eligibility of Deferred Action for Childhood Arrivals (DACA) Recipients and Certain Other Noncitizens for A Qualified Health Plan through an Exchange, Advance Payments of the Premium Tax Credit, Cost-Sharing Reductions, and a Basic Health Program, took effect on November 1, 2024, providing crucial public health and economic benefits not only for DACA recipients, who have been in the United States since at least 2007, but also for the wider community.

Today’s motion explains that because the incoming Trump Administration will stop defending the rule, these 13 states are stepping in to defend it. President-elect Trump criticized the final rule during his 2024 campaign, and his previous administration declined to defend both DACA and the ACA. The states’ motion explains that they have a right to step in where the federal government will stop defending this critical policy.

The states’ motion also explains the many ways they will be harmed if a court eliminates the rule. In general, DACA recipients contribute an estimated $6.2 billion in federal taxes and $3.3 billion in State and local taxes each year and provide critical financial support to their families, including their over 250,000 U.S.-citizen children. They are employed by companies, nonprofit organizations, and government agencies and institutions, work in crucial roles in the medical profession and the U.S. military, are enrolled in public and private universities, and have even started their own businesses that employ other residents, including U.S. citizens.

But DACA recipients previously lacked access to the ACA exchanges, even though Congress extended access to ACA exchanges to all who are “lawfully present” – a term that consistently is used to include those whom the U.S. Department of Homeland Security has temporarily chosen not to remove via deferred action. The Final Rule remedies these discrepancies.

According to data in the Final Rule, DACA recipients are three times more likely to be uninsured than the general U.S. population. Uninsured populations drive up healthcare costs overall and worsen public health, resulting in increased premature deaths, uncompensated care costs, increased medical debt, reduced spending power, lost productivity, and absenteeism from work and school. The Final Rule, by expanding insurance access to DACA recipients, helps this population and aids the states generally.

Besides the obvious benefits to states that reduce the rate of uninsured populations, such as improved public health and better health outcomes, states that operate their own exchanges – like Minnesota – can also benefit from including DACA recipients in their exchanges because larger and more diverse risk pools may keep premiums lower for everyone.

In addition to Minnesota, other jurisdictions joining today’s filing include New Jersey, Arizona, California, Colorado, Delaware, Hawaii, Illinois, Maryland, Michigan, New Mexico, Nevada, Oregon, and Vermont.