Editor’s note: This story was condensed for space. The original version of this story can be found at californiahealthline.org.
The Trump administration’s controversial decision on Tuesday to scrap the DACA program does more than put nearly 800,000 “Dreamers” in fear of deportation and losing their jobs. It threatens the health care of thousands of young adults who either have job-based insurance or whose incomes qualify them for Medicaid in California and several other states.
“I am very upset,” said Paulina Ruiz, a cerebral palsy patient and Medi-Cal recipient who organizes for the Coalition for Humane Immigrant Rights of Los Angeles and lives near the city. “I don’t know what’s going to happen to my health.”
Trump said the program, which was started under President Obama in 2012, rewards lawbreakers who hurt Americans by taking their jobs and depressing wages, a claim some economists dispute. Attorney General Jeff Sessions said Tuesday that the program was unconstitutional because it was a unilateral executive action on a proposal that had been repeatedly rejected by Congress.
Trump, who has suggested he has conflicting sentiments about the program, left open the door for Congress to change it. “I have a love for these people, and hopefully now Congress will be able to help them and do it properly,” he said, according to The New York Times. But the newspaper noted that he did not call for bipartisan legislation to restore its protections.
DACA allows immigrants between the ages of 16 and 31 who were brought to the United States undocumented as children to receive work permits and temporary protection from deportation. Those who qualified were explicitly barred from receiving federal health benefits through Medicaid, Obamacare exchanges or other programs.
Many DACA recipients now have jobs with health insurance. In addition, California, New York, Massachusetts, Minnesota and the District of Columbia have used their own funds to cover low-income Dreamers through Medicaid, according to Tanya Broder, a Berkeley-based senior staff attorney for the National Immigration Law Center.
There are an estimated 220,000 DACA recipients in California, the largest number in the country. Those who meet income requirements (138 percent of the federal poverty level or $33,534 for a family of four) can qualify for coverage under the state’s “Permanently Residing in the United States under Color of Law” eligibility category.
That coverage is now in question. In California, those at risk of losing Medicaid are 19 and older, because the state has under a separate law decided to cover low-income children, regardless of immigration status, through age 18.
“Nobody will lose coverage in the Medi-Cal program immediately,” said Ronald Coleman, director of government affairs for the California Immigrant Policy Center, an immigrant advocacy group. But Coleman worries about what happens after March 5, when DACA’s protections will end.
The Department of Health Care Services, which oversees Medi-Cal, was contacted on Sept. 5, could not provide a comment.
Marielena Hincapié, executive director of the National Immigration Law Center, told reporters in a conference call on Sept. 5 that she expects DACA recipients to start losing their job-based health insurance, and that she is particularly concerned about the effect of the president’s decision on the mental health of DACA recipients.
“The need for mental health services will only be greater,” she said.
Jocelin Reyes made a similar point at a protest in downtown Los Angeles, observing that DACA helped provide a sense of safety.
“A lot of people don’t understand how much fear we had” about being deported, said Reyes, 19, who is about to start school at the University of California-Santa Barbara. “Now that fear has tripled.”
Another demonstrator, DACA recipient Maria Garcia, 22, said that losing her job as a hotel receptionist would mean the end of her job-based health insurance.
“If they take away my DACA, I’ll get fired,” she said. “And then what will I do for health insurance?”
State Sen. Ricardo Lara (D-Bell Gardens) said ending DACA would only hurt “the well-being of these American children who have played by the rules.” And they could end up having to go to costly emergency rooms for medical care.
Lara, who led the charge to get all undocumented children covered by Medi-Cal, said one possible solution in California would be to increase the age limit for Medi-Cal coverage for kids from 18 to 26.
“We have to answer this call to ensure that our DACA students and workers are not pushed aside,” he said.
The California Medical Association said that terminating DACA could indeed hurt the health care workforce.
“Our nation’s health care system has the largest percentage of foreign-born and foreign-trained workers of any industry in the country. Already facing a national shortage of physicians and other health care professionals, revoking DACA could also undermine patient care and disrupt medical schools and hospitals for decades to come,” said California Medical Association President Ruth E. Haskins in a statement.
This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.