By Jim Garcia
As the executive director and one of the founders of Clinica Tepeyac, a community health clinic that sees more than its share of uninsured patients, I applaud the Supreme Court’s ruling to uphold the Patient Protection and Affordable Care Act, the President’s health care reform law that increases access to care for millions of Americans.
Since we opened our doors at Clinica Tepeyac nearly 20 years ago, we committed ourselves to caring for all patients who cross our threshold, the vast majority of whom have no access to health insurance and who are desperately in need of basic health care services.
It should be no surprise then that we do not focus on whether patients are citizens or undocumented immigrants when they enter our clinic. We believe that everyone in our community needs and deserves high quality health care services.
Unfortunately, the health care reform law leaves undocumented immigrants largely outside of the discussion. We understand the political reality of today, where Congress is gridlocked on the issue of immigration. Despite this impasse, the recent Supreme Court decision advances the idea that we are a nation that cares for its sick, and that the time has come for us to expand our definition of “we” to fully reflect our neighbors and our communities.
The National Immigration Law Center outlines exactly how the law treats undocumented immigrants. It notes that our undocumented neighbors, the people who care for our grandparents, who prepare our food, who clean our hotel rooms, and whose children play side by side with ours at school, are considered:
- Ineligible to purchase private health insurance through the state insurance exchange;
- Ineligible to receive premium tax credits or cost-sharing reductions to reduce health care costs;
- Exempt from the individual mandate to purchase health insurance; and
- Ineligible for Medicare, non-emergency Medicaid and the Child Health Insurance Program (CHIP).
Although the Affordable Care Act expands health insurance coverage for many more people, the only way undocumented immigrants can access care is through emergency Medicaid services (only if the person is extremely low-income) or through emergency room visits — an extremely costly option for our community.
By leaving immigrants outside of the health care reform tent, our nation pursues the most expensive option and one that will yield dire health outcomes for some of the most vulnerable people in our society.
Like other historic civil rights issues, we understand the movement toward covering all people in the United States will happen in time. It’s very easy for those of us with coverage to understand this and be patient, but the reality for undocumented immigrants who are sick is urgent. They need care now, not when we as a country get around to it.
Although we celebrate the court upholding the health care reform law, we can’t take our work gloves off or close our laptops just yet. Now is the time to make this the kind of country we want it to be: a country that honors all people living in its borders and believes that we should care for all of our neighbors when they are sick.
Jim Garcia is executive director of Clinica Tepeyac.