Can DACA Recipients Still Get Health Insurance?

Health insurance for DACA recipients still exists in 2026, but the ACA Marketplace is no longer one of the options. A federal rule that took effect on August 25, 2025, removed DACA recipients from the definition of “lawfully present,” ending eligibility for Marketplace plans and federal premium subsidies.¹ The paths that remain are employer coverage, COBRA after a job loss, state-funded programs in a handful of states, private plans purchased directly from insurers, and community health centers for out-of-pocket care.

What the 2025 Rule Changed

On June 25, 2025, the Centers for Medicare and Medicaid Services published a final rule excluding DACA recipients from the “lawfully present” definition used for ACA Marketplace enrollment. The rule took effect two months later, reversing a 2024 rule that had briefly opened Marketplace coverage to DACA recipients.¹

Under the new rule, DACA recipients cannot enroll in a qualified health plan through the Marketplace, cannot receive advance premium tax credits or cost-sharing reductions, and cannot enroll in a Basic Health Program in states that operate one. Exchanges were directed to terminate coverage for any DACA recipients still enrolled when the rule took effect, and insurers were required to send termination notices to those enrollees.²

Federal Medicaid and CHIP are also unavailable. Federal law bars Medicaid payment for individuals who are not lawfully admitted for permanent residence, except for emergency medical services.³ With the two largest federal programs off the table, the remaining routes to coverage are private, state-funded, or employer-based.

Employer-Sponsored Coverage

For most working DACA recipients, a job that offers health benefits is the cheapest and strongest form of coverage available. DACA grants work authorization, and employers that offer health benefits must extend them to DACA employees on the same terms as anyone else. There is no immigration-status exception in employer group health plans.

You typically enroll during your company’s annual open enrollment window or within 30 days of your hire date. Employers usually pay a substantial share of the premium, which makes group coverage far more affordable than anything you could buy on your own. The coverage itself is generally strong because employer plans still have to meet ACA requirements for essential health benefits.

If you’re comparing job offers, treat the health benefit as part of the pay. The employer’s share of the premium is effectively tax-free income, and group rates are almost always lower than individual rates for the same coverage.

COBRA if You Lose Job-Based Coverage

If you lose a job that provided health insurance, or your hours drop below the threshold for coverage, federal COBRA rules let you continue the same employer group plan. COBRA applies to employers with 20 or more employees and has to be offered after a qualifying event regardless of immigration or residency status.

The catch is cost. You pay the full premium, including the portion your employer previously covered, plus up to a 2% administrative fee. Coverage lasts up to 18 months after a job loss, and up to 36 months in some situations such as divorce or a dependent aging off a parent’s plan. It’s expensive, but it keeps you on the same plan with the same doctors and pharmacy network. If you’re in the middle of treatment or managing a chronic condition, that continuity is often worth the price while you look for something else.

State-Funded Programs

Several states use their own money to cover residents regardless of immigration status, and DACA recipients are eligible in those programs. Eligibility turns on income and state residency, not status. As of late 2025, the states with the broadest coverage include:⁴

California covers all income-eligible adults regardless of immigration status through its state-funded Medi-Cal expansion.
Colorado offers subsidized Marketplace-style coverage through OmniSalud for individuals with incomes up to 300% of the federal poverty level.
Oregon covers all income-eligible adults through a state-funded expansion of the Oregon Health Plan.
Washington provides subsidized coverage through Cascade Care and extended state-funded coverage at lower income levels starting in 2024.
Minnesota extended state-funded coverage to income-eligible adults regardless of immigration status in January 2025.
New York covers individuals 65 and older regardless of immigration status through state-funded Medicaid.
Illinois covers low-income adults 65 and older through Health Benefits for Immigrant Seniors, though new enrollment has been paused since 2023.
The District of Columbia covers low-income adults 21 and older through its locally funded Healthcare Alliance program.

Program details change often. If you live in one of these states, contact the state health benefits agency directly to confirm current eligibility rules and how to apply.

Buying Private Insurance Directly

You can buy health insurance directly from any insurance company without going through the Marketplace. These off-marketplace individual plans follow the same ACA rules on pre-existing conditions, essential health benefits, and coverage standards.

The drawback is that no federal subsidies apply. Without premium tax credits or cost-sharing reductions, you pay the full premium, which for individual coverage generally runs several hundred dollars a month or more depending on age, location, and plan tier. An insurance broker who handles individual plans can help you compare options at no cost to you, since brokers are paid by the insurer.

Short-term plans are also sold outside the Marketplace and usually cost less. They can exclude pre-existing conditions, impose coverage limits, and skip benefits that ACA plans have to include, so they work best as gap coverage between jobs rather than as a long-term solution.

Emergency Care and Community Health Centers

Two federal protections guarantee emergency care no matter your insurance or immigration status. They aren’t substitutes for coverage, but they matter.

EMTALA, the Emergency Medical Treatment and Labor Act, requires every Medicare-participating hospital with an emergency department to screen and stabilize anyone who arrives with an emergency condition, including active labor, regardless of ability to pay.⁵ Hospitals cannot turn you away or delay treatment to check insurance or immigration status.

Emergency Medicaid, separately, covers the cost of emergency treatment for people who meet income limits but don’t qualify for regular Medicaid because of immigration status. It applies to conditions where the absence of immediate care could seriously jeopardize your health, impair bodily functions, or cause organ dysfunction, and it specifically covers emergency labor and delivery.³ It pays only for the emergency itself, not follow-up care or prescriptions afterward.

For routine care, federally qualified health centers are usually the most practical option if you don’t have insurance. Over 1,300 of these centers operate nationwide, offering primary care, dental care, behavioral health, and pharmacy services to anyone, regardless of immigration status or ability to pay. Fees are set on a sliding scale based on household income and family size:⁶

At or below 100% of the federal poverty guidelines, you get a full discount and may pay only a nominal fee.
Between 100% and 200% of the federal poverty guidelines, you get partial discounts across at least three graduated tiers.
Above 200% of the federal poverty guidelines, you pay standard fees.

Federal law prohibits these centers from denying service because you can’t pay. You can find the nearest one at findahealthcenter.hrsa.gov.

If You Had a Marketplace Plan Before the Rule Took Effect

If you received advance premium tax credits while enrolled in a Marketplace plan during 2024 or the portion of 2025 before your coverage ended, you’ll need to reconcile those credits on your federal tax return using IRS Form 8962.⁷

Reconciliation compares the advance payments your insurer received on your behalf against the premium tax credit you were actually entitled to based on your final income and household size for the year. If the advance payments were more than your actual credit, you owe the difference back. For tax year 2025, repayment caps may limit what you owe if your household income was below 400% of the federal poverty level. Starting with tax year 2026, those caps go away and you have to repay the full excess.⁸

If you reported income and household changes to the Marketplace as they happened, the advance payments were probably adjusted along the way and any repayment will be small. If you didn’t, the gap could be significant. Either way, if any APTC was paid on your behalf, Form 8962 has to be filed with your return.

1
Centers for Medicare & Medicaid Services. 2025 Marketplace Integrity and Affordability Final Rule
2
Federal Register. Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability
3
Office of the Law Revision Counsel. 42 USC 1396b – Payment to States
4
KFF. State Health Coverage for Immigrants and Implications for Health Coverage and Care
5
Centers for Medicare & Medicaid Services. Emergency Medical Treatment and Labor Act (EMTALA)
6
Health Resources & Services Administration. Chapter 9: Sliding Fee Discount Program
7
Internal Revenue Service. Publication 974 (2025), Premium Tax Credit (PTC)
8
Internal Revenue Service. Updates to Questions and Answers about the Premium Tax Credit