The White House held its breath as Affordable Care Act open enrollment began for a second time last week. In addition to the prospect of reliving the website malfunctions that occurred when the ACA began, the number of people who take advantage of the ACA this time around is projected to be low. Based on U.S. Department of Health and Human Services (HHS) calculations, 9.1 million people are expected to enroll by the end of the enrollment period in February. That is just 1.8 million more than the number enrolled in August.


Given this mediocre prediction, there has been much talk among government officials and healthcare advocates about how to have the best, most robust outreach possible. But these conversations most often ignore the people locked out of healthcare because of their immigration status.


The Affordable Care Act, or Obamacare, as many call it, is rightfully seen as President Obama’s most pivotal achievement. Even his detractors support some of the act’s provisions. Thanks to the Affordable Care Act, more than 10 million people have gained access to health insurance since it first began. Insurance companies can no longer discriminate against people based on a preexisting condition or charge more because of gender, and they are now required to cover prevention and wellness benefits at no charge.


Making health a national priority by ensuring as many people as possible are covered is immensely important for obvious reasons -- anyone could get hurt or sick at any time. No person should live in fear that one accident or illness could threaten an entire family's economic security.


However, there are millions of people living and working in the United States who are unable to access the important benefits made available by the ACA. It has been reported that 112,000 people lost their ACA coverage this year because they did not verify their eligibility based on citizenship and immigration status. Moreover, there are more than 11 million people living in the United States who are ineligible for the ACA at the national level simply due to their immigration status.


More than 550,000 of them are young people, often called “Dreamers,” who came to the United States as children and are, at present, lawfully residing here. These Deferred Action for Childhood Arrivals (DACA) program recipients, who have been given reprieve from deportation, were explicitly carved out of the ACA through announcements made by CMS and HHS on Aug. 28, 2012, issued as federal regulations and guidance. The announcement altered federal rules for DACA-eligible people by excluding them from health insurance options available to others with deferred action status.


Immigrants work, pay taxes, and contribute to our communities and our economy. They should have the same responsibilities and opportunity to participate in health care as their friends and neighbors. Further, it’s better and more affordable for all of us when immigrants can participate in the health care system their tax dollars support. Affordable health coverage improves access to preventive care, protects public health, prevents suffering, and puts less strain on under-resourced and costly emergency services. The impact of the large number of uninsured on our economy is huge. It results in a loss of $65 billion to $130 billion annually, consisting of lost wages, absenteeism, and family leave. 


Offering DACA recipients the same opportunity for affordable health insurance as people in other deferred action categories would be a strong step toward ending the staggering numbers of uninsured immigrants across the country. This is something the Obama administration can and should take action on immediately for the hundreds of thousands of young people in this program, and a step that would benefit the country as well.


Of course, the number of uninsured would decrease dramatically if everyone, regardless of immigration status, had the opportunity to receive health coverage under the ACA. Everyone needs health care at some point and everyone should pay a fair share.


At this moment, as we await the president’s executive order on immigration reform and begin the second ACA enrollment, this one adjustment would make sure we at least cover the 550,000 young people who have been left out.


Jorawar is a lawyer and reproductive health policy expert at the National Asian Pacific American Women’s Forum and a Public Voice Fellow of The OpEd Project