Attorney General Mayes Joins Effort to Protect Affordable Care Act Access for Dreamers
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Attorney General Mayes Joins Effort to Protect Affordable Care Act Access for Dreamers

Arizona leads coalition of 14 states defending health insurance eligibility for DACA recipients against legal challenges.

PHOENIX – Attorney General Kris Mayes announced Wednesday that Arizona, alongside 13 other states, is stepping in to defend health insurance access for Deferred Action for Childhood Arrivals (DACA) recipients—known as Dreamers—against legal challenges. The coalition’s motion to intervene comes as the incoming Trump administration is expected to withdraw federal support for the rule granting Affordable Care Act (ACA) access to DACA recipients.

“The incoming administration’s decision to abandon this rule is not just wrong—it’s harmful,” Mayes said in a press release. “Denying Dreamers affordable health insurance drives up costs for everyone, damages public health, and undermines the contributions these individuals make to our communities. Arizona will not stand by while this essential lifeline is stripped away.”

Background on the Final Rule and Legal Challenges

The Biden administration issued a regulation in 2024 expanding ACA exchange eligibility to Dreamers, a long-overdue step to address healthcare disparities. The Final Rule, which took effect on November 1, 2024, allows DACA recipients to purchase qualified health plans, receive premium tax credits, and benefit from cost-sharing reductions.

However, a coalition of states led by Kansas filed a lawsuit against the U.S. Department of Health and Human Services (HHS) and the Center for Medicaid and Medicare Services (CMS), challenging the rule. The U.S. District Court for the District of North Dakota partially blocked its implementation in certain states but left it in place in most, including Arizona. President-elect Trump criticized the regulation during his campaign, signaling his administration’s likely withdrawal from defending the rule in court.

Why the Final Rule Matters

Dreamers, who have lived in the U.S. since at least 2007, contribute $6.2 billion in federal taxes and $3.3 billion in state and local taxes annually. Many work in essential sectors, including healthcare, education, and the military, and support their U.S.-citizen children and families.

Before the Final Rule, DACA recipients were excluded from ACA exchanges despite being lawfully present—a term that typically includes individuals granted deferred action by the U.S. Department of Homeland Security. The exclusion left Dreamers three times more likely to be uninsured than the general U.S. population, burdening healthcare systems with higher costs, increased medical debt, and worse public health outcomes.

Expanding insurance access helps Dreamers secure affordable healthcare, reduces uncompensated care costs, and improves productivity and public health outcomes for all communities.

States Standing Together

In addition to Arizona, the coalition defending the Final Rule includes New Jersey, California, Colorado, Delaware, Hawaii, Illinois, Maryland, Michigan, Minnesota, New Mexico, Nevada, Oregon, and Vermont. The states argue that eliminating the rule would cause widespread harm, both economically and socially.

“DACA recipients are vital members of our workforce and communities,” said Mayes. “This rule not only promotes fairness but strengthens public health and economic stability for everyone.”

The coalition’s motion underscores the importance of continuing to defend policies that protect access to healthcare and address long-standing inequities.