Thousands of undocumented immigrants who arrived in the country as children can now sign up for subsidized health plans through California’s insurance marketplace.

The expansion comes from a rule change approved in May under President Joe Biden’s administration. Under the change, Deferred Action for Childhood Arrivals recipients — known as Dreamers — are included in the Affordable Care Act and can purchase insurance federal or state marketplaces such as Covered California. Enrollment for eligible Dreamers in California opened earlier this month.

The future of this expansion remains uncertain given President-elect Donald Trump’s promise to overhaul the nation’s immigration policy. During his first term, he backed efforts to end both the ACA and DACA which grants legal residence and work permits to some undocumented immigrants brought to the U.S. as children.

Still, state officials encourage uninsured residents to take advantage of the new opportunity. Roughly 40,000 DACA recipients in California gained eligibility, said Jessica Altman, executive director of Covered California.

“Right now, you are eligible for all the financial assistance we make available. … Let’s focus on what we have right now,” Altman said.

Altman noted that concerns around DACA eligibility existed before the presidential election results. In August, a group of Republican attorneys general filed a federal lawsuit against Biden’s health insurance marketplace expansion.

The lawsuit argues the expansion burdens states running their own marketplaces and encourages undocumented immigrants to stay in the country. California and other states have since filed a brief in defense of the federal rule change.

“We’ve always known there’s uncertainty and unfortunately that’s something that our DACA recipients have dealt with,” Altman said.

Covered California began its special open enrollment for those DACA recipients on Nov. 1. Those who enroll before the end of the month will have coverage beginning in December.

The enrollment period ends Dec. 31 for uninsured residents wanting coverage by the start of 2025. About 90% of Covered California enrollees receive financial help to pay their monthly premiums.

This new benefit follows a successful and more than decadelong effort in California to expand Medi-Cal eligibility to all undocumented immigrants.

The need for the Covered California expansion exists, however, as many people remain uninsured even with eligibility for low-income programs, said Shelby Gonzales, vice president for immigration policy at the Center on Budget and Policy Priorities.

The uninsured population is disproportionately Latino and Black, immigrants and are not primarily English speakers, Altman added. This can lead to challenges in navigating the system, lack of language services and a fear of interacting with the government.

The UCLA Center for Health Policy Research estimates that more than 1.3 million uninsured Californians qualify for subsidies through Covered California or are eligible for Medi-Cal.

“Having access to affordable health coverage is important for everyone in our nation,” Gonzales said.

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