Attorney General Mayes Acts to Protect Affordable Care Act Access for Dreamers

PHOENIX - Attorney General Mayes today announced that she 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.

"The incoming administration's apparent decision to abandon the defense of this rule is not just wrong-it's harmful. Denying Dreamers the ability to purchase affordable health insurance hurts public health, drives up costs for everyone, and undermines the contributions these individuals make to our communities," said Attorney General Mayes. "Arizona will not stand by while an essential lifeline for thousands is stripped away. We are stepping in to defend what the federal government won't-basic fairness and access to healthcare."

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 Arizona.

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 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 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 allowed 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.

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

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