On April 26, 2023, the Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM) that expands the existing definition of individuals who are lawfully present in the United States to include individuals defined as Deferred Action for Childhood Arrivals (DACA). DACA is a policy designed to safeguard approximately 800,000 individuals commonly referred to as “DREAMers.” These are young people who arrived in the United States as children without proper legal documentation. DACA enables this population to seek a driver’s license, social security number, and work permit through the program’s provisions, but does not grant citizenship.  

The expanded CMS definition of who is lawfully present would allow for eligible DACA individuals to be considered for a Qualified Health Plan (QHP), Basic Health Plan (BHP), Medicaid, or the Children’s Insurance Health Plan (CHIP). This adjusted definition is expected to expand affordable health insurance coverage options to approximately 129,000 individuals. Additionally, this change would allow DACA individuals eligible for subsidies such as Advance Premium Tax Credits (APTC) and/or Cost-Sharing Reductions (CSRs) if they meet the required qualifications.  

The public comment period on this rule closed on June 23, 2023. If the proposed rule passes as written, the changes will go into effect November 1, 2023, including access to coverage for the remainder of plan year 2023.