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UncategorizedGaping holes in safety net for uninsured

Gaping holes in safety net for uninsured

Undocumented residents make up half of the 3 million Californians who still lack health insurance


By Anna Challet

MARCH 19, 2015 — The safety net for uninsured Californians is full of holes – and those holes are much bigger for the state’s undocumented people.

That’s one of the main findings of a new study by the statewide health care advocacy coalition Health Access. The organization’s executive director Anthony Wright says the “uneven safety net” puts the state’s remaining uninsured in a position to “live sicker, die younger, and be one emergency away from financial ruin.”

“Counties should maintain strong safety nets for the remaining uninsured, through the county-led programs that provide primary and preventative care,” Wright said on a press call last week. “Counties that do not serve the undocumented should reconsider this policy, and focus their indigent care programs on the remaining uninsured population that actually has the most need for a safety net.”

Over a year into the full implementation of the Affordable Care Act, some 3 million Californians still lack health insurance. For many, that’s because coverage is still unaffordable. And almost half of the 3 million are undocumented, and thus shut out from federal health programs.

By law, counties have to provide care to low-income individuals who are uninsured and don’t qualify for other programs. But, says Wright, “Counties interpret this responsibility widely and wildly, in very different ways.”

For example, of the state’s 58 counties, only 10 “explicitly serve the undocumented in their programs for those who meet other qualifications such as income,” says Wright. “The rest do not serve the undocumented outside of emergency care.”

The study found that the number of people enrolled in county-based care programs for the uninsured varied widely according to different counties’ eligibility requirements.

Counties that have more inclusive eligibility requirements, in terms of income and immigration status, still have thousands of people using their indigent care programs – in Los Angeles, for example, over 80,000 people are enrolled in the My Health LA program, which is open to undocumented immigrants, and assigns individuals to community clinics.

But counties that have more stringent eligibility requirements have far fewer people enrolled. Counties like Merced, Placer, and Tulare report that they now serve no one in their health care programs for the poor and needy.

That’s not because there isn’t a need, according to Wright, but because “those programs aren’t geared to the remaining uninsured that are left.”

Sacramento County is one of the 48 counties that don’t provide care to undocumented immigrants. It used to, but stopped in 2009 during the financial crisis.

Carlos Garcia, who spoke on the call along with Wright, is undocumented and recently moved to Sacramento from San Mateo. He hurt his leg in an accident and now the leg is infected. He says he was prescribed antibiotics instead of more comprehensive treatment because he doesn’t have health coverage, but he can’t even afford the medication.

He’ll need to drive back to San Mateo for further treatment – San Mateo is one of the 10 counties that provide care to the undocumented – but he’s worried about being able to pay for gas.

“I haven’t been able to work because of this,” he said through a translator. “I feel desperate.”

The proposed “Health For All” bill (SB 4) could help Garcia if it passes this year. The legislation, originally introduced in 2014 and re-introduced in 2015 by Senator Ricardo Lara (D-Los Angeles), would guarantee health coverage to everyone in the state, regardless of immigration status.

“County-based programs should be a bridge to a statewide solution, as being discussed here in the state capital, that would extend affordable coverage to all Californians,” says Wright.

“Our health system is stronger when everyone is included,” he says.

This story comes from New America Media.

Tim Redmond
Tim Redmond has been a political and investigative reporter in San Francisco for more than 30 years. He spent much of that time as executive editor of the Bay Guardian. He is the founder of 48hills.
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  1. I don’t have a lot of use for religious mumbo-jumbo whether it’s christian dogma, muslim fundamentalism or eastern touchy-feely new-agey spirituality.

    When you’re ready for a secular debate, LMK.

  2. Well, I’m not religious so I guess I’m just gonna take my chances.

    Are you sure you wouldn’t be happier in the bible belt than in this nexus of immorality?

  3. Ha! You must be a lawyer. Or a financial advisor. You’re gonna win an argument with St. Peter? I think not. And you’ll be comfortable right up until the moment you start feeling the heat.

  4. OK, so aside from karmic psycho-babble and doom-laden religious prognostications, nothing?

    The concept of a “sin” is, itself, subjective and riddled with religious ideology.

    Sorry, but I’m still comfortable. If I get to the pearly gates and have to explain myself to St. Peter, I’m sure I’ll figure out something to say.

  5. What I mean MisterEllis, is that for every action, there is an opposite and equal reaction. Sometimes the reaction is instant, sometimes it takes 500 years. This is neither threat nor blackmail; it’s physics, and when applied to human affairs, often referred to a “metaphysics.” So yes, we will all pay for the sins of our fathers, if you know what I mean, and I think you do.

  6. No, I don’t know what you mean.

    Unless of course what you mean is the same kind of “blackmail threat” argument that Greg is also employing here to try and intimidate people into agreeing with your ideological agenda.

    And it seems to me that someone like you with all that compassion for suffering would never stoop to such a tactic.

  7. Well, I’m glad you’re happy. But that will not prevent the chickens from coming home to roost, if you know what I mean, and I think you do.

  8. I don’t know how it’s working for the majority of people in the world because they are not my concern.

    Not everyone can be saved. I feel comfortable with the healthcare that we have in the US.

  9. So how’s that working out for the majority of people in the world? If you think you can be comfortable while others suffer, you got another think comin’.

  10. What you or I think people should be paid doesn’t really matter. It is society and the market that decides on your pay.

    The Hippocratic Oath says a lot of things but it does not demand or require that a medical professional treat unlimited numbers of people regardless of compensation.

    People are attracted to the professions, like medicine, dentistry, law etc. because of the good pay and because of the continuous demand for those services ensuring financial security.

    I would not want to be treated by a badly-paid doctor who is worrying about where his next mean is coming from. If he has the skills to heal me, I do not resent him being wealthy.

  11. I think schoolteachers and nurses should be paid more than coders or designers or planners or banksters. The Hippocratic Oath says nothing about compensation; it’s all about service to your fellow humans. If you go into medicine for the money, you will make a lousy doctor.

  12. You know, I’m pretty sure that even the socialist nations in Europe that have free healthcare draw the line at aliens and illegals.

    If there was a place on the planet that anyone who was sick could get free unlimited healthcare, then it would be over-run with parasites seeking free unlimited healthcare.

  13. The rest of the “industrialized” world has free universal healthcare paid for by the taxpayers. Visitors to these countries are not refused treatment because they don’t have money. Healthcare is a human right, and should not be not another mechanism to fleece the public. But then, that’s what our “culture” is all about.

  14. I am aware that some nations like the UK spend less on healthcare than we spend on MediCare and MediCaid, and everyone is covered (although not foreigners, I believe)

    But then not many Americans go to the UK for healthcare because it is better here.

    Regardless, the issue here is more about illegals, and nationwide there is scant support for giving them all free public healthcare. While if SF wants to go its own way on that, the cost should be put to the voters who will then decide whether we want to be a healthcare sanctuary city for the third world

  15. The number opposed to ObamaCare was far larger than the small number who identify as libertarians.

    The number who oppose free unlimited healthcare for illegals probably includes a majority of Democrats. In fact it was the Democrats in Congress who rejected the public option, and that excluded illegals anyway

  16. Not so unlimited. Health care for all could be budgeted for, and the costs would come out to be surprisingly reasonable, especially when compared to, say, unlimited war.

  17. It’s not a matter of me even disagreeing with your argument, although I do, as you predict.

    It’s the manner in which you present an argument as a threat. you might as well point a gun at them and demand money if you’re going to argue that way.

    Unlimited free healthcare for anyone who just happens to be here, legally or not, implies an unlimited liability funded from limited resources. I’m not aware that the majority support that. Heck, even a Democrat-controlled Congress didn’t pass the public option of ObamaCare

  18. It was Greg trying to use implied threats as an argument and a form of blackmail, and not the poor, who generally behave with dignity and integrity.

  19. Engaging in a crime spree or terrorist activity is a conscious decision. Inadvertently contracting and spreading an infectious disease is not. Poor people aren’t blackmailing us with the threat of tuberculosis.

  20. I wouldn’t put it in quite those terms, but actually… yes. Investing money in the poor yields better social outcomes on a whole range of measures. I’m sure you’ll never be convinced of that; even though that view is supported by mountains of research, this is something that just goes against your whole worldview.

    On the issue of health care, however, the side benefits for the rest of us are even more clear and direct. If an undocumented mother takes her child to the doctor to take care of her child’s pneumonia, you can be pretty sure that it will yield direct benefits for somebody’s citizen child who won’t be catching it. Likewise, I support sick leave for everyone. Well, I support it because, you know… common decency. But I also don’t want someone with a cold or flu making my lunch.

  21. Stop being ridiculous. Libertarians will never choose compassion or humanity over greed. They live in fear that their annual tax bill will increase by 5 cents if we ensure that all who live in SF have adequate healthcare.

  22. Greg, that sounds a lot like the argument that we should throw money at poor people or else they will engage in a crime spree.

    Or we should give in to terrorists because otherwise they might hurt us.

    In other words, you want to blackmail us into bankrolling your socialist nirvana. Not gonna happen.

  23. As life-affirming as your anecdote is, I am not aware of any nation that has an official policy of giving free unlimited healthcare to all foreigners regardless of their disposition or legality.

  24. I suppose it’s too much to ask folks like Mister “Sam” Ellis to support health care for the undocumented out of decency and humanity. Fine then, do it out of selfishness. Infectious disease doesn’t care if you’re a citizen. To be fine with your own kids getting sick, just because you want the kids of undocumented folks to stay sick -that’s not just heartless. It’s stupid. It’s cutting off your nose to spite your face.

  25. Actually, you do. I was in Yelapa,Mexico a few years back and developed a nasty bronchial infection. The only medical facility was a clinic staffed by a nurse who treated me and then refused payment and gave me a lecture about how in Mexico, health care is a right,etc.

  26. Yeah, Anna, if you break the law of the land, you don’t get to benefit from the welfare generosity of that land.

    If I show up illegally in Mexico, do I get free unlimited healthcare there? Don’t think so.

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