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As one of the earliest enrollees in the Deferred Action for Childhood Arrivals program, Houa Chea had access to education and a job.
But he never saw a doctor growing up. His father, a Cambodian temple sculptor, came to Minnesota on a temporary religious worker visa and the family couldn’t afford out-of-pocket medical care.
“I don’t recall ever going in for checkups,” Chea said. “I recall asking my parents that I wanted to play a sport, but they said ‘Well, 1) we can’t afford it, and 2) if you ever get injured, we don’t have health care, so we just simply can’t afford you getting hurt or needing to go to the hospital.”
Thanks to a rule finalized by the Biden administration late last year, DACA recipients can now access subsidized health care via the Affordable Care Act (ACA), except in 19 Republican-led states that challenged the rule last summer.
The Trump administration is unlikely to defend the Biden rule, so Minnesota Attorney General Keith Ellison, along with 13 other state attorneys general, stepped in two weeks ago to defend the new provision that expands access to the preventive care that Chea, now 27, was denied growing up.
The motion to intervene was filed just days before President Donald Trump’s inauguration in response to a lawsuit from a coalition of states headed by Kansas. The suit challenges a federal rule put in place by the Biden administration in November expanding access to health care through the ACA to include DACA recipients, known also as “Dreamers.”
“Allowing Dreamers to purchase health insurance through the Affordable Care Act is a common-sense measure that has been working well,” Ellison said in the announcement. “It is deeply disappointing that some are playing politics with the health of our neighbors, and I will not stand for it.”
Health policy officials and experts anticipate efforts by Trump in his second term to weaken the ACA, the landmark piece of legislation enacted in 2010 that now provides health care to more than 45 million Americans. The new rule now allows DACA recipients to access the ACA marketplace and purchase subsidized plans, which was barred to them before their enrollment period began in November.
Trump has also lived up to promises of aggressive action on immigration in his first week, attempting to do away with established programs like refugee resettlement and birthright citizenship.
Among the programs potentially in danger is the DACA program. It was established in 2012 via executive order by President Barack Obama to prevent the deportation of children who arrived and have lived continuously in the United States since 2007, granting them legal status in two-year intervals that are renewable.
It aims to protect teens and young adults who arrived young and only know the United States as their home, allowing them to continue pursuing education and employment.
“They are people who, many of them, know nothing else but Minnesota as their home,” said Rodolfo Gutierrez, executive director of Hispanic Advocacy and Community Empowerment through Research (HACER), a St. Paul-based nonprofit. ”They are people who grew up within this system. They went to high school, college even, and they are people contributing to the economy.”
As of September, there are more than 537,000 active DACA recipients nationwide.
Republicans have attempted to end the program several times since its inception, including a directive from Trump during his first term in 2017 rescinding DACA. Though the U.S. Supreme Court upheld the program in 2020, the move allows renewals for current DACA recipients but put a pause in new applications.
A lawsuit from Texas and several other states challenging a “final” regulation formalized by the Biden administration in 2022 is still tied up in the courts.
Former DACA recipient Alejandra Rivera, 24, of West St. Paul, also lacked access to affordable health care growing up. Her mother paid out-of-pocket for Rivera to get preventative care.
“I was able to go to the eye clinic, all of my dentist appointments and my doctor checkups,” Rivera said. “I did my best to take advantage of it.”
Thanks to those checkups, doctors discovered Rivera had multiple ovarian cysts and removed them before they ruptured, which can be life-threatening.
Chea, a mechanical engineer who now lives in Prior Lake, finally received health care in 2021, when he was able to get insurance through his employer. He said he feels fortunate to be able to see a doctor.
“If you don’t have the health care, you just kind of avoid going to the hospital, or do your best to not get injured, or just pray that you don’t have an accident,” he said.
Though the provision in the ACA allows for DACA recipients, who are usually young people, to access affordable health care, the adults, parents and caretakers in their lives still have a harder time getting the care they need.
Before MinnesotaCare, a state health care program for low-income residents, expanded its eligibility late last year to include undocumented residents, access to health care for the approximately 81,000 undocumented people statewide was extremely limited due to high costs for out-of-pocket care.
“Many people were really excited about the opening of MinnesotaCare starting last year — I know a good number of people who applied in November and December,” said Gutierrez. “There is not much for people who have no documents when it comes to access to health care.”
This was true for Rivera and her mother, who couldn’t get any coverage due to their immigration status until receiving a visa more than a decade after arriving.
“She would go to clinics and they would deny her [care] because she doesn’t have insurance, or they would say that they had Spanish interpreters and then they didn’t so there was miscommunication in interpreting,” Rivera said. “She received just a lot of bad negligence from the health care system.”
The lack of health insurance meant rare visits to the dentist for Rivera’s mother, which eventually led to surgery for gum disease to prevent a severe infection — a surgery that cost thousands of dollars for which she had to pay out of pocket.
“I think had my mom or immigrants, undocumented or documented, had affordable health insurance access to get those checkups, it could prevent them from just bigger long-term problems,” she said. “My mom being the biggest example — if she were able to go to her dentist appointments and get her teeth cleaned and checked, she wouldn’t have had this severe gum disease that she has now.”
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Mohamed Ibrahim is the health reporter for Sahan Journal. Before joining Sahan, Mohamed worked for the nonprofit news site, MinnPost, covering public safety and the environment. He also worked as a reporter… More by Mohamed Ibrahim
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