Counties Cutting Health Care for Undocumented Immigrants

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(Sacramento, CA)
Wednesday, May 27, 2009

Last week, Yolo County followed the lead of Sacramento and Contra Costa counties by eliminating these services. As Capital Public Radio’s Kelley Weiss reports, these cuts could burden already-struggling community clinics and emergency rooms and cause a public health threat.


You might not know it, but counties can choose to expand medical services for the poor to illegal immigrants. This is more common in states with higher numbers of undocumented residents, like California. But now with the economy tanking some are pulling back on that policy.


“I feel like the Grinch that stole Christmas.”


That’s Dr. Joe Iser who heads Yolo County's health department. He says the county faces a $24 million shortfall and the move will save the county more than a million dollars. Iser estimates illegal immigrants make up about half of the people on the county’s program for the poor. It’s hard to tell though because in the past providers didn’t check legal status, but starting in July they will. Iser says this was a tough cut but it will protect other important programs.


“Otherwise the rest of my department might have to give up funds to do the public health kinds of things that we do, including the swine flu response, including immunizations and so on.”


Yolo County is the third Northern California county to do this, following the lead of nearby Sacramento and Contra Costa counties. And that could mean these undocumented immigrants won’t go to the doctor as much. I talked to several of them at an immigrant resource center. Josie Enriquez works there and helped translate the interviews.


Claudia Diaz, her husband and their four children are here illegally from Mexico. Her husband manages his lung condition with medicine but soon she says they won’t be able to afford it. And, she’s afraid he’ll end up in the hospital like he has in the past.


Diaz translation:  “The time that he went he couldn’t breathe and he was hospitalized for a day and he was off for two days and whenever he takes time off, how are we going to pay for our expenses?”


DeHaven: “When it comes down to taking care of the health care needs of a regular citizen versus an undocumented immigrant then nine out of ten times it’s the undocumented immigrant that gets cut.”


Tad DeHaven is a budget analyst at the non-profit, libertarian CATO Institute. He says it makes sense that people like Diaz would lose benefits when money’s short.


“There’s not going to be a lot of broad based sympathy from folks who are paying taxes to fund these services and might be unemployed right now and are facing their own personal problems.”


Still many providers in the region say these cuts are shortsighted policy and could hurt everyone. They worry that if thousands of undocumented immigrants cut back on doctor’s visits, they might go untreated for communicable diseases like tuberculosis, measles, gonorrhea or HIV.


Robin Affrime is the CEO of CommuniCare Health Centers in Yolo County. These centers provide care to the poor and uninsured and they contract with the county to help cover some of these costs. She warns turning away undocumented immigrants could create a public health threat.


“We’re worried about any kind of epidemic we just saw that with the swine flu, what if people aren’t feeling well and they’re afraid to come in until they are really, really sick? It can have some really unintended, really negative consequences on the health of the whole community.”


Affrime says health care providers are supposed to keep people healthy and they’re not the immigration police. So she says they’ll still see these patients, but they will have to pick up the tab for those who can’t pay cash. And that will be the case for emergency rooms too -- under federal law they have to treat everyone.


The bottom line is that these cuts are a sign of the economic times.


“Waves of desperation are rolling across the country at the local level.”


Robert Pestronk is the executive director of the National Association of County and City Health Officials. He says some Texas counties are considering similar cuts.


“More elected officials are going to be facing this very challenging situation of figuring out what to do with the limited resources they have and then to face the consequences health and otherwise as a result of the decisions that they have to make.”


As California debates how to fill its more than $24 billion budget hole the outlook gets even more grim for county and state programs. In fact, Governor Schwarzenegger is now proposing major cuts in health benefits for some of the state’s poor, legal immigrants.