For many DACA recipients, access to health care is still a dream deferred

It is very impressive to see all the changes that a Social Security card and a work permit can make for undocumented immigrants living in the United States.

When the Deferred Action for Childhood Arrivals (DACA) program began in 2012, thousands of young people became eligible to finally obtain the nine-digit Social Security number that would allow them to have quasi-legal status in the country.

DACA recipients saw their lives changing, since the would be able to legally work, obtain a driver’s license, travel abroad and go to college and four-year universities. But there’s one benefit that didn’t come with DACA: the ability to purchase a health care plan on Obamacare’s exchanges.

When the Affordable Care Act was rolled out in 2014, it excluded undocumented immigrants and DACA recipients from buying health coverage through government sponsored health exchanges and from receiving premium tax credits or other savings on marketplace plans.

This issue caught my attention, since many DACA recipients are giving back to the country in different ways. Many are working on a degree, while others are working professionals or trying to move their way up in their jobs. They pay taxes and help to improve the economy, but what about their health?

For many DACA recipients, the lack of health insurance is not a problem, since they don’t often visit a doctor. The more common options include home remedies or over the counter medicine.

Many times, however, their only option is “Don’t get sick.”

A light at the end of the tunnel appeared for some undocumented immigrants and DACA recipients in California when Medi-Cal benefits became available for low-income children and families, regardless of immigration status.

In order to qualify, however, people have to meet certain requirements, including a family income that does not exceed 138 percent of the Federal Poverty Level (FPL).

I was interested to know what were the options for those who didn’t qualify for Medi-Cal. Some DACA recipients were told they made too much to qualify under the low-income group, but they were too poor to afford medical insurance on their own.

During my reporting for Dreamers In Search of An Affordable Health Care, I spoke to a single mother, who is a DACA recipient and didn’t qualify for Medi-Cal benefits because she made about $1,000 over the maximum FPL. Her only option was to go to community clinics and get health care on the spot.

She didn’t seek out medical insurance on her own because she said she couldn’t afford it. Her situation — she exceeded the FPL and didn’t have the option of obtaining health insurance through work, nor did she qualify for subsidies from the government to purchase insurance on her own — left her out of the health care system.

SB 10 allows California to seek a federal waiver to allow undocumented immigrants and DACA recipients to use their own money to buy health insurance through Covered California. Under the ACA, states can apply for a waiver to modify provisions of the law based on guidelines set by the U.S. Department of Health and Human Services.

If the waiver is approved, undocumented immigrants will be able to purchase health insurance on California’s exchange, but they won’t be eligible for the subsidies that make exchange plans more affordable for lower-income residents.

I also interviewed a family of four where the daughter — a DACA recipient — was able to qualify for Medi-Cal, but the father who suffers diabetes did not qualify, due to his immigration status.

It was interesting, however, to hear representatives of community clinics trying really hard to inform the community about health care options. Health care clinics, workshops and community fairs are where many people find out about their options. Many of them are unaware of Medi-Cal or other programs.

During my reporting, I attended two health care workshops organized by AltaMed and the UCLA Labor Center. Families who didn’t think they had coverage options were able to get basic exams and follow-up appointments.

I was told in two community clinics that they have payment plans for people who don’t qualify for health insurance. The Ability to Pay program is also available at the Los Angeles County hospital; people pay only for the time they visit the doctor and that payment counts for the whole month. If patients needs prescriptions or a follow-up appointment, their one time payment covers the visits as long as it is within the same month.

While working on my series, I also wanted to find out how much SB 10 — if approved by the federal government — might benefit the undocumented community. The bill would open the state’s health care marketplace to undocumented immigrants. But immigrants wouldn’t be eligible for subsidies.

When people heard about this bill, some said it was more of a symbolic measure of inclusion, rather than a realistic help for those in need of health care services. Others said it is a step forward and it helps to include all..

After my stories were published, I received a lot of positive messages, but I also received messages from opponents of expanding coverage to undocumented immigrants.

“When this disaster of a law (ACA) passed, the American people were told under no uncertain terms that coverage under Obamacare would not be extended to illegal immigrants,” Congressman Darrell Issa said in a statement. “Yet, here we are 6 years later and the state of California is already trying to wipe away this promise. It’s time the Administration keep its word and honor the rule of law.”

That debate will continue. But working on this project taught me how important health care is for all people, regardless of immigration status. I came to realize DACA recipients are just one small group affected by a much bigger issue that still awaits resolution.

You can read Jacqueline Garcia's series, “Dreamers in search of affordable health care,” here.