Expanded Health Insurance Options on NY State of Health for DACA Recipients – Essential Plan & Qualified Health Plans

Both the Essential Plan and Qualified Health Plans have expanded the citizenship/immigration criteria to include individuals granted deferred action through the Deferred Action for Childhood Arrivals (DACA) program. Essential Plan’s inclusion of DACA recipients is effective August 1, 2024, and Qualified Health Plans inclusion will be November 1, 2024.

The expansion allows DACA recipients with higher incomes (up to 250% FPL) to qualify for Essential Plan coverage.  Previously, DACA recipients with incomes up to 138% FPL were covered by NYS state-funded Medicaid. These enrollees have now been transitioned from Medicaid to Essential Plan coverage with the same insurer. New York State of Health (NYSoH) communicated this change through notices, texts, and emails.  Some DACA recipients will remain in Medicaid (and not be transitioned to Essential Plan), including pregnant people and those in their 12-months of post-partum coverage, those who are receiving long term care services, and those ineligible for Essential Plan due to age.

In addition, beginning November 1, 2024, DACA recipients will be considered “lawfully present” and therefore eligible to purchase a Qualified Health Plan (QHP) on the NY State of Health/Marketplace (NYSoH). With this change, DACA recipients will be able to have coverage with a QHP and benefit from QHP premium tax credits.

Individuals who want to apply for health insurance offered through the NY State of Health/Marketplace (MAGI Medicaid, Child Health Plus, Essential Plan and Qualified Health Plans) can apply directly at https://nystateofhealth.ny.gov/, or with the assistance of a Navigator.