Skip to main content.

Undocumented Immigrants Await a New Option for Health Care Coverage in California

A special series by the Reporting on Health Collaborative

About This Series

Many immigrants feel isolated in America – suffering that can turn toxic over time.

Six news outlets joined together as the Center for Health Journalism Collaborative to highlight the interplay between immigration status and health. The USC Annenberg project involves Mundo Hispánico (Atlanta), New America Media (California and New York), Radio Bilingüe (Fresno and Washington), WESA Pittsburgh, Univision Los Angeles and Univision Arizona.

Undocumented Immigrants Await a New Option for Health Care Coverage in California

April 08, 2014


In the Los Angeles apartment she rents, 65-year-old Juana opened a small kit that she uses to help manage her diabetes.

Inside is insulin that she injects and a small blood sugar monitor. Ten years ago, Juana attended a health fair out of curiosity.

“I didn’t feel bad; I remember that it was the first time I had gone to one of those places,” she remembered.

There, at the fair, they told Juana that she had diabetes. It was totally unexpected.

“I spent a good while crying,” she said.

Juana does not have immigration documents, which is why she did not want to identify herself with her full name.

Because of her immigration status, her options for receiving medical care are limited. She does not qualify for public medical insurance like Medicaid (or Medi-Cal in California), nor can she apply for insurance through the new exchange established through the Affordable Care Act.

Like many undocumented immigrants, Juana receives medical care to control her illness in a community clinic. The consultations are free, or offered at a very low cost, but even so, her situation is precarious. Juana only earns $4,500 per year cleaning houses. She has to spend almost $1,000 per year on medications that the clinic does not cover.

“For example, if I need eye drops, or a special foot powder for diabetics, I have to pay for it,” she said. “And those products aren’t cheap.”

Exhausted from the burden of her age, and with progressive deterioration of her body due to her diabetes, Juana is now paying more attention to the news. She recently found out that there is a proposal in the California legislature to offer health insurance to people who, like her, do not have documents.

“When undocumented Californians seek care, the types of options are ‘Band-Aid’ options,” said Imelda Plascencia, co-author of “Undocumented and Uninsured,” a recent research project of the UCLA Labor Center. The center’s research showed that three out of four of undocumented young people need care from a doctor, but most do not have health insurance.

“Seventy-four percent of the immigrant youth population has received some type of ‘Band-Aid’ care, like community clinics or public hospitals, which offer a temporary or quick remedy, but do not recognize the need for preventative or long-term health,” Plascencia said.

The UCLA study, as well as other recent research, recommend expanded medical coverage for undocumented people. Some of the proposals include establishing binational insurance that could cover preventative care in the United States, and the most expensive services such as surgical interventions in Mexico. Other proposals would increase government funding to institutions that offer free or low-cost services.

A few months ago, state senator Ricardo Lara proposed the legislative initiative “Health Care for All” to offer health insurance to the undocumented population.

“It would be a program similar to Obamacare, in which immigrants who are able to pay for health insurance can do that and those who cannot pay are covered by Medi-Cal,” Lara said.

On the national Radio Bilingüe program Línea Abierta, Lara asserted that the undocumented community contributes $2.7 billion to the state economy. That’s about twice the estimated amount that is spent caring for them in emergency rooms.

It is still unclear where the additional funds would come from to finance a health insurance program for undocumented people like the one the senator is proposing. Lara says that he is analyzing several options. One would be a tax on exports, he said.

“Another strategy that we are looking at is if we add a fee to drivers’ licenses,” he said.

Lara’s proposal generated immediate support among those who offer medical care to undocumented people, like Mario Chávez, director of community relations for the Saint John’s Well Child & Family Center network of clinics. The majority of the more than 65,000 patients that these clinics care for each year are Latino, and most of them do not have documents.

Los Angeles is one of the few counties in California that offers a program that covers preventative services, hospitalization, pharmacy, and laboratory procedures for low-income patients who do not qualify for Medi-Cal. Through the Healthy Way L.A. Unmatched program, the county grants $54 million per year to the more than 200 community clinics and health centers in the county to cover undocumented patients.

But Chávez says that it is not enough to cover demand at St. John’s.

“St. John’s gets $800,000, and that covers, out of our 35,000 visits, only 8,500 visits,” said Chávez.

Even more worrisome, says Chávez, is that in recent years at Saint John’s, an increasing number of undocumented patients with chronic illnesses have been registered.

“For us it is very critical that not only the $54 million continue, but that the amount of money grows to invest in immigrant communities,” said Chávez. “Because when a crisis comes, because at the end of the day, a person without insurance, where does he go? Instead of coming to our clinic, they are going to end up at the emergency room.”

Healthy Way L.A. Unmatched serves a little more than 100,000 undocumented people in the city. This represents a small part of the uninsured undocumented people, estimates Edward Chávez, from One L.A., a coalition of community, religious, and trade union organizations.

“Right now there are a million people in Los Angeles County who are left out of healthcare coverage,” said Edward Chávez.

Chávez says that in the coming months, One L.A. will pressure Los Angeles County to increase health resources for undocumented people, and they will also ask the California legislature to approve Lara’s initiative, “Health Care for All.”

“We believe that to have health insurance is a right and not a privilege,” Edward Chávez said.

Juana said she will be watching this initiative, with hope.

“Hopefully, for humanity, they’ll pass it,” she said.

Recent Stories

Thirty years ago, Fresno County was obligated to provide care to everyone who needed it, regardless of their immigration status. Now a judge has determined that the county no longer has to offer them medical services.

While children show different responses to early trauma, depending on factors such as their age, coping mechanisms, and family support, experts say that research shows that witnessing a parent's arrest or deportation leads to a complex series of problems.

Exhausted from the burden of her age and diabetes, Juana now pays more attention to the news. She recently learned of a California proposal to offer health insurance to people who are undocumented.

A Mexican-American woman decided to convert her house into a health insurance registration center. She invited her family and neighbors, most of them uninsured. Could this be a model strategy to sign up more Latinos?

All California counties have to offer a minimum of free or very low-cost health services to uninsured, low-income residents who do not qualify for subsidized health insurance and cannot pay for private insurance. But one county is trying to change this.

The consequences of separating parents from children can include causing or exacerbating mental health problems such as depressive or anxiety disorders.

In 2014, fellows Alonso Yáñez and Annabelle Sedano collaborated on a project highlighting shortcomings in detention facilities for undocumented immigrants operated by for-profit companies. As Obama reconsiders outsourcing detention centers, this project offers early warnings of problems to come.

Fatal errors and lack of adequate medical care in immigration detention centers bring suffering to detainees and their families.

As many as 1 in 4 of those detained have chronic medical conditions. Medical neglect can lead to deteriorated health and, in Fernando Dominguez Valdivia's case, death.

A Mexican father is released from detention thanks to a psychological evaluation used as evidence in court.