When Paloma Bouhid started working as a concierge at Walt Disney World Resort in Florida seven years ago, it was the first time she received health insurance.

But the lifeline she found through her work was unexpectedly eclipsed in 2020, when, aged 26, she lost her job in a series of mass layoffs.

“The first thing I thought was ‘Oh my God, I don’t have a job’ and then you realize very quickly that that also means I’m uninsured,” said Bouhid, whose the family immigrated from Brazil to Tampa in 1999, he said.

Bouhid is one of approximately 580,000 young adults without legal status who have been in the United States since childhood and are working or studying under the Deferred Action for Childhood Arrivals program, also known as the name of DACA. An overwhelming majority were born in Mexico and other Latin American countries.

DACA recipients like Bouhid don’t have access to federally funded health insurance, but that could change soon: President Joe Biden’s administration is finalizing a proposed rule that would allow them access.

Since bouncing back by starting a small business specializing in organizing and decluttering in early 2021, Bouhid has struggled to make monthly payments of $500 towards her private health insurance, calling it “absolutely unaffordable”. .

“Knowing now that I have this opportunity to have affordable health care, it definitely takes a weight off my shoulders,” Bouhid said.

The DACA program has helped many eligible young immigrants access better paying jobs and educational opportunities, often allowing them to feel secure in their ability to seek and pay for health care services, according to Roberto Gonzales, professor of sociology and education at the University of Pennsylvania. which has followed the lives of more than 400 DACA recipients since the program was implemented in 2012.

“But not all DACA recipients have been able to access employment or educational opportunities that have enabled them to receive health care benefits,” Gonzales said.

About a third of DACA recipients — about 34% — have no health insurance coverage, according to the Department of Health and Human Services.

“As a result, they were limited to local clinics with long wait times and emergency rooms as primary sources of health care,” Gonzales said. “This meant that often illnesses and injuries were not treated in a timely manner.”

“For some DACA recipients we met, this resulted in worsening conditions,” he added.

Paving the way to better health outcomes

The Department of Health and Human Services’ Centers for Medicare and Medicaid Services on Thursday submitted a proposed rule that would change the definition of “legal presence” to include DACA recipients, for the purposes of Medicaid coverage and the law. on affordable care.

The agency said the proposed rule will be published in the Federal Register by the end of the month to give the public an opportunity to submit comments before the rules are finalized.

“If this is finalized, I will definitely benefit from it,” said Gretel Rodríguez, a 22-year-old DACA recipient from New Jersey. “I’ve been in this country since I was 4 years old, but I haven’t had decent access to healthcare.”

Universities often require students like Rodríguez and Katia Rubio Leal to have health insurance upon registration. The requirement has forced them both to start paying expensive premiums that barely cover their needs, the two women said.

“Let’s say I’m in the gym and an injury comes up, that’s when it’s accessible,” the Honduran-born Rodríguez said of her health insurance, adding that it doesn’t cover not her eye exams, the glasses she wears. or medical examinations for his asthma. She has to pay for these services out of pocket.

Rubio Leal, a 21-year-old DACA recipient, also recalled spending more than $2,000 on limited health insurance coverage during her freshman year of college at Rockhurst University in Kansas City, Missouri — an amount that in its first year had become unsustainable, she said. .

By the time Rodríguez heads to law school after graduating from Rutgers University in May, DACA recipients like her “could see their access to healthcare improve significantly” if the rule is finalized, a said Gonzales.

“They could access a primary care provider, which would allow them to be more proactive in managing their health and seeking medical interventions for specific conditions,” he said. “It would immediately lead to better health outcomes.”

For Rubio Leal, who was born in Mexico and raised in Arkansas, being able to access federally funded health insurance while she pursues a degree in biomedical engineering would be a huge improvement. As a child who had no insurance coverage, Rubio Leal recalled a case where his parents reimbursed a dentist with food to perform emergency dental work they could not. not afford.

“I just wish I could go to sleep at night knowing that my health is under control. And if it’s not, I can easily get help,” Rubio Leal said.

She aspires to pursue a doctorate, with the ultimate goal of improving the way prosthetic limbs are constructed and expanding their accessibility.

Continue to seek “a permanent solution”

DACA recipients pay about $6.2 billion in federal taxes each year, already funneling funds into federal health insurance programs they may soon be able to access.

Teissy Angel Ramirez, 28, was born in Mexico and raised in California. She moved to Nevada three years ago to care for her mother after she was diagnosed with abdominal cancer.

She is currently working as a phlebotomist while completing an Associate of Arts degree at the College of Southern Nevada in hopes of transferring to the University of Nevada, Las Vegas to study public policy.

Angel Ramirez has worked in the medical field since the age of 18, beginning as a caregiver for autistic patients at a mental and behavioral health center and later for elderly and disabled patients.

Jobs have provided her with health insurance coverage, as she lacks affordable insurance options due to her immigration status.

Angel Ramirez’s goal is to work in public policy and advocacy for immigrant and human rights. Having expanded access to affordable health care would mean not having to choose between your dream career and access to health care.

“We can’t forget that there are still people who don’t have health insurance,” she said.

Gonzales added that while expanding health care to DACA recipients “would be an important step forward, especially for the most vulnerable,” he stressed that DACA “is a temporary and partial program that does not lead to citizenship and could very well be terminated”.

Although the program has been around for a decade, it has faced legal challenges from the previous administration and Republican-run states. DACA has been closed to new registrants since July 2021, while a lawsuit filed by Texas and other GOP-led states makes its way through the courts.

To improve the chances of DACA surviving legal battles, the Biden administration implemented a rule in October that turned the program into a federal regulation.

A Texas federal judge is expected to rule on the legality of the new rule this year.

“What DACA recipients need more than anything is a permanent solution,” Gonzales said.

For “dreamers” like Rodríguez, this permanent solution is a path to citizenship for them and for all undocumented immigrants.

“That’s the main goal,” she said. “That’s how I stay grounded in my activism.”

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