Con el Fin de DACA, Jóvenes Inmigrantes Temen por Su Salud

September 7, 2017 by · Leave a Comment 

Para Paulina Ruiz, de 26 años, tener un estatus migratorio legal es algo más que ir a la escuela o tener un trabajo. Se trata de mantenerse sana.

La joven graduada de la Universidad de California en Los Ángeles, cuyos padres la trajeron de México a Estados Unidos ilegalmente hace dos décadas, tiene parálisis cerebral, una condición neurológica que le diagnosticaron poco después de su nacimiento.

Ruiz contó que en el pasado confiaba en salas de emergencia para su atención, y rara vez podía ver a especialistas. Después de años de atención médica inconsistente y de usar una silla de ruedas inapropiada, desarrolló problemas en el riñón y la espalda.

En 2012, Ruiz calificó para el programa federal de Acción Diferida para los Llegados en la Infancia (DACA), que temporalmente la protegió de la deportación. Al vivir en California, eso significó que pudo obtener Medi-Cal, la versión estatal del Medicaid para los estadounidenses de bajos ingresos, y ver regularmente a un médico.

La polémica decisión de la administración Trump el martes 5 de septiembre de eliminar el programa DACA hace más que poner casi a 800.000 “dreamers” (soñadores) bajo el miedo a la deportación y la pérdida de sus puestos de trabajo. Amenaza el cuidado de salud de miles de adultos jóvenes como Ruiz, quienes tienen seguro a través de sus empleos o, por su nivel de ingresos, califican para el Medicaid en California y en varios otros estados.

“Estoy muy molesta”, dijo Ruiz, quien es organizadora para la Coalición por los Derechos Humanos de los Inmigrantes de Los Ángeles y vive cerca de la ciudad. “No sé qué va a pasar con mi salud”.

La decisión entrará en vigor en seis meses, a menos que el Congreso presente un plan alternativo. Trump ha dicho que el programa, que comenzó bajo el presidente Barack Obama en 2012, recompensa a los infractores, quienes, dice Trump, perjudican a los estadounidenses al tomar sus empleos y bajar los salarios, una afirmación que algunos economistas refutan. El procurador general, Jeff Sessions, dijo el martes que el programa era inconstitucional porque fue una acción ejecutiva unilateral sobre una propuesta que había sido rechazada por el Congreso en reiteradas oportunidades

Trump, quien ha sugerido que tiene sentimientos contradictorios sobre DACA, dejó abierta la puerta para que el Congreso cambie. Según The New York Times, Trump dijo “tengo un amor por estas personas, y espero que ahora el Congreso pueda ayudar y hacer lo correcto”pero el periódico señaló que el presidente no pidió una legislación bipartidista para restaurar sus protecciones.

DACA permite que los inmigrantes entre 16 y 31 años que fueron traídos a los Estados Unidos ilegalmente cuando eran niños reciban permisos de trabajo y obtengan una protección temporal contra la deportación. Aquellos que calificaron fueron excluidos explícitamente de recibir beneficios de salud federales a través del Medicaid, de los mercados de seguros del Obamacare, y de otros programas.

Muchos beneficiarios de DACA ahora tienen trabajos con seguro de salud. Además, cuidades como California, Nueva York, Massachusetts, Minnesota y el Distrito de Columbia han utilizado su propio dinero para cubrir a los “dreamers” de bajos ingresos a través del Medicaid, según Tanya Broder, abogada laboral del National Immigration Law Center.

Se estima que 367,000 personas califican para DACA en California, y hay 220,000 beneficiarios en el estado, el mayor número en el país. Aquellos que cumplen con los requisitos de ingreso – el 138% del nivel federal de pobreza o $33,534 para una familia de cuatro – pueden calificar para cobertura bajo una categoría denominada “Permanently Residing in the United States under Color of Law”.

Esa cobertura ahora está en peligro. En California, aquellos que corren el riesgo de perder el Medicaid tienen 19 años o más, porque el estado, a través de otra ley, decidió cubrir a todos los menores de bajos ingresos hasta los 18, sin importar el estatus migratorio. Esta decisión no estaba conectada al programa DACA.

Con la acción del gobierno federal, “nadie perderá inmediatamente la cobertura en el programa Medi-Cal”, dijo Ronald Coleman, director de asuntos gubernamentales del California Immigrant Policy Center, un grupo de defensa de inmigrantes. Pero Coleman está preocupado por lo que sucederá después del 5 de marzo, cuando las protecciones de DACA terminen, a menos que el Congreso tome medidas para proteger el programa.

El Departamento de Servicios de Atención Médica, que supervisa al Medi-Cal, no pudo comentar sobre el tema el martes, dijo una portavoz.

Marielena Hincapié, directora ejecutiva del National Immigration Law Center, dijo a periodistas en una conferencia telefónica el martes que teme que los beneficiarios de DACA comiencen a perder su seguro de salud basado en el trabajo. Hincapié agregó que está particularmente preocupada por el efecto de la decisión del presidente sobre la salud mental de los beneficiarios de DACA.

“La necesidad de servicios de salud mental simplemente será mayor”, dijo.

En el centro de Los Ángeles el martes, durante una protesta contra la decisión del gobierno de Trump, Jocelin Reyes remarcó lo mismo. Reyes dijo que las protecciones de DACA habían ayudado a los jóvenes inmigrantes a desterrar miedos, ya que fueron capaces de conseguir trabajo, ir a la universidad o escuelas de posgrado, y salir de la clandestinidad.

“Mucha gente no entiende cuánto miedo tuvimos” de ser deportados, dijo Reyes, de 19 años, quien comenzará a estudiar en la Universidad de California-Santa Bárbara. Ahora su miedo se ha triplicado.

Otra manifestante y beneficiaria de DACA, María García, de 22 años, dijo que perder su trabajo como recepcionista de un hotel significaría el fin de su seguro de salud, cobertura en la que ella confía para la terapia física que recibe por una lesión en la rodilla y para cualquier otra enfermedad.

“Si me quitan mi DACA, me despedirán”, dijo. “Y entonces, ¿qué voy a hacer para tener seguro médico?”

El senador estatal Ricardo Lara (demócrata de Bell Gardens) dijo que terminar con DACA sólo perjudicaría “el bienestar de estos niños estadounidenses que han cumplido con las reglas”. Y podrían terminar teniendo que ir a costosas salas de emergencia para recibir atención médica.

Lara, quien lideró la iniciativa para que todos los niños indocumentados fueran cubiertos por el Medi-Cal, dijo que una posible solución en California sería elevar el límite de edad para la cobertura del Medi-Cal para los jóvenes de 18 a 26 años.

“Tenemos que responder a este llamado para asegurar que nuestros estudiantes y trabajadores de DACA no sean desplazados”, dijo.

La Asociación Médica de California denunció que terminar con DACA podría dañar la fuerza laboral de atención médica.

“El sistema de atención de salud de nuestra nación tiene el mayor porcentaje de trabajadores nacidos en el extranjero y extranjeros entrenados comparado con cualquier industria en el país. Ya enfrentando una escasez nacional de médicos y otros profesionales de salud, la revocación de DACA también podría socavar la atención del paciente y perturbar las escuelas de medicina y hospitales durante décadas”, dijo Ruth E. Haskins, presidenta de la Asociación Médica de California, en un comunicado.

Ana B. Ibarra contribuyó con esta historia.

Esta historia fue producida por Kaiser Health News, que publica California Healthline, un servicio editorialmente independiente de la California Health Care Foundation.

Move To End DACA Leaves Some Young Immigrants Fearing For Their Health

September 7, 2017 by · Leave a Comment 

LOS ANGELES — For 26-year-old Paulina Ruiz, having legal immigration status is about more than going to school or holding a job. It’s about staying healthy.

The University of California-Los Angeles graduate, whose parents brought her from Mexico to the U.S. illegally two decades ago, has cerebral palsy, a neurological condition diagnosed shortly after birth.

In the past, Ruiz said, she relied on emergency rooms for her health care and rarely could see specialists. She developed kidney and back problems after years of inconsistent medical care and using an inappropriate wheelchair.

But in 2012, she qualified for the federal Deferred Action for Childhood Arrivals (DACA) program, which temporarily protected her from deportation. In California, that meant she could get Medi-Cal, California’s version of the Medicaid insurance program for low-income Americans, and regularly see a doctor.

The Trump administration’s controversial decision on Tuesday to scrap the DACA program does more than put nearly 800,000 “Dreamers” in fear of deportation and losing their jobs. It threatens the health care of thousands of young adults like Ruiz, who either have job-based insurance or whose incomes qualify them for Medicaid in California and several other states.

“I am very upset,” said Ruiz, who organizes for the Coalition for Humane Immigrant Rights of Los Angeles and lives near the city. “I don’t know what’s going to happen to my health.”

The decision is set to take effect in six months, unless Congress comes up with an alternative plan. Trump has said the program, started under President Obama in 2012, rewards lawbreakers who hurt Americans by taking their jobs and depressing wages, a claim some economists dispute. Attorney General Jeff Sessions said Tuesday that the program was unconstitutional because it was a unilateral executive action on a proposal that had been repeatedly rejected by Congress.

Trump, who has suggested he has conflicting sentiments about the program, left open the door for Congress to change it. “I have a love for these people, and hopefully now Congress will be able to help them and do it properly,” he said, according to The New York Times. But the newspaper noted that he did not call for bipartisan legislation to restore its protections.

The program allows immigrants between the ages of 16 and 31 who were brought to the United States illegally as children to receive work permits and temporary protection from deportation. Those who qualified were explicitly barred from receiving federal health benefits through Medicaid, Obamacare exchanges or other programs.

Many DACA recipients now have jobs with health insurance. In addition, California, New York, Massachusetts, Minnesota and the District of Columbia have used their own money to cover low-income Dreamers through Medicaid, according to Tanya Broder, a Berkeley, Calif.-based senior staff attorney for the National Immigration Law Center.

There are an estimated 220,000 DACA recipients in California, the largest number in the country. Those who meet income requirements — 138 percent of the federal poverty level or $33,534 for a family of four — can qualify for coverage under the state’s “Permanently Residing in the United States under Color of Law” eligibility category.

That coverage is now in question. In California, those at risk of losing Medicaid are 19 and older, because the state under a separate law decided to cover all low-income children, regardless of immigration status, through age 18. That decision was not connected to the DACA program.

With the federal government’s action, “nobody will lose coverage in the Medi-Cal program immediately,” said Ronald Coleman, director of government affairs for the California Immigrant Policy Center, an immigrant advocacy group. But Coleman worries about what happens after March 5, when DACA’s protections will end — unless Congress takes action to protect the program.

The Department of Health Care Services, which oversees Medi-Cal, could not provide a comment on Tuesday, a spokeswoman said.

Marielena Hincapié, executive director of the National Immigration Law Center, told reporters in a conference call on Tuesday that she expects DACA recipients to start losing their job-based health insurance. Hincapié said she is particularly concerned about the effect of the president’s decision on the mental health of DACA recipients.

“The need for mental health services will only be greater,” she said.

At a protest in downtown Los Angeles Tuesday against the Trump administration’s decision, Jocelin Reyes made a similar point. She said DACA’s protections had helped put some young immigrants’ fears to rest, as they were able to get jobs, attend college or graduate school and come out of hiding.

“A lot of people don’t understand how much fear we had” about being deported, said Reyes, 19, who is about to start school at the University of California-Santa Barbara. “Now that fear has tripled.”

Another demonstrator, DACA recipient Maria Garcia, 22, said that losing her job as a hotel receptionist would mean the end of her job-based health insurance — coverage she relies on for physical therapy for a knee injury and any time she gets sick.

“If they take away my DACA, I’ll get fired,” she said. “And then what will I do for health insurance?”

State Sen. Ricardo Lara (D-Bell Gardens) said ending DACA would only hurt “the well-being of these American children who have played by the rules.” And they could end up having to go to costly emergency rooms for medical care.

Lara, who led the charge to get all undocumented children covered by Medi-Cal, said one possible solution in California would be to increase the age limit for Medi-Cal coverage for kids from 18 to 26.

“We have to answer this call to ensure that our DACA students and workers are not pushed aside,” he said.

The California Medical Association said that terminating DACA could indeed hurt the health care workforce.

“Our nation’s health care system has the largest percentage of foreign-born and foreign-trained workers of any industry in the country. Already facing a national shortage of physicians and other health care professionals, revoking DACA could also undermine patient care and disrupt medical schools and hospitals for decades to come,” said California Medical Association President Ruth E. Haskins in a statement.

Ana B. Ibarra contributed to this report.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

L.A. County Votes to Create Foster Youth ‘Bill of Rights’

July 20, 2017 by · Leave a Comment 

The Board of Supervisors voted Tuesday to create a “bill of rights” for foster youth that lays out rights, resources and services available to kids and their foster parents.

California has its own such bill, but county officials said it’s outdated and doesn’t include county programs.

Supervisor Janice Hahn championed the move.

“The former foster youth who spoke at (Tuesday’s) meeting told us how frustrating it can be maneuvering the foster care system when you do not know your own rights or the resources available to you,” Hahn said. “This bill of rights will be a way for both foster youth and foster parents to know every tool, service and program that has been created to support them.”

Examples include a policy that allows social workers to act in lieu of a parent to help a foster child get a driver’s license and the fact that foster youth have access to MediCal until age 26.

Six current and former foster youth will join the bill of rights working group. Hahn had originally proposed two representatives but upped the total based on feedback at the board meeting.

The group, to be led by the Department of Children and Family Services, is also expected to include county lawyers, mental health workers, probation officers, health care professionals and representatives of various community- based organizations.

Advocates said that concerns about navigating the foster care system deter some potential foster parents at a time when the need is great.

Others noted the complexities of the foster care system.

“I’m a 40-something-year-old woman, a lawyer and a mom. I’ve worked and volunteered in the child welfare system for over 15 years and I still struggle to keep up with what the laws are,” Wende Nichols-Julien told the board. “The people within the system, the people affected by these laws deserve to know what the laws say.”

In Nichols-Julien’s case, understanding the laws helped a girl she was mentoring avoid moving into a group home while she was working to reunite with her family.

A state effort to reform foster care requires that foster youth have access to specialized mental health treatment, transitional support as they move from foster to permanent home placement, connections with siblings and extended family members and transportation to school.

Roughly 35,000 children and young adults receive child welfare services from the Department of Children and Family Services. A little less than half live outside their homes in a foster care or group home.

A report back is expected in 120 days.

Fearing Deportation, Parents Worry About Enrolling Undocumented Kids In Medi-Cal

May 18, 2017 by · Leave a Comment 

Luz felt relieved and grateful when she learned that her 16-year-old son qualified for full coverage under Medi-Cal. Now, she worries that the information she provided to the government health program could put her family at risk of deportation.

Luz’s son is one of nearly 190,000 children who have enrolled in Medi-Cal since California opened it to undocumented children last year. Luz, her husband and her son came to Merced, Calif., from Mexico without papers about 10 years ago. Luz asked that the family’s last name not be used, for fear of being identified by federal immigration authorities.

In the current political climate, immigration and health advocates worry that children, like Luz’s son, will drop out of Medi-Cal and that new kids won’t enroll out of concern that personal information may be used to deport families.

Luz would need to renew her son’s coverage in October, but she remains undecided even though the program paid for his hospital visit when he injured a foot. “I’m still thinking about it,” she said.

Last May, the state Department of Health Care Services (DHCS) implemented the new “Health For All Kids” law allowing California children under 19 to receive full Medi-Cal benefits, including dental care and mental health, regardless of their immigration status. Previously, undocumented children could receive only emergency care through Medi-Cal.

California followed Illinois, Massachusetts, New York, Washington and the District of Columbia in offering state-supported health coverage to children in the country illegally.

Medi-Cal is California’s version of the federal Medicaid program for people with low incomes. The federal government pays for a significant portion of the California program, as it does for all states. But coverage for undocumented kids is entirely funded by the state.

From last May to through April 6, 189,434 undocumented children signed up for the program, according to the most recent state data. The health care services department estimates that another 61,000 children are eligible but not enrolled. Advocates say now is the time for a push to sign up these “harder-to-reach” children and to encourage those already in the program to stay.

Immigrant families have become more reluctant to share personal information with government programs because of the Trump administration’s planned changes in health care and immigration policies, according to a recent survey of 62 individuals working for pediatric practices, community clinics, local public health departments and hospitals serving immigrant communities throughout the state.

Immigrants are also increasingly skipping doctor appointments because of similar concerns, according to the survey, conducted in March by the advocacy group Children Now.

Kelly Hardy, Children Now’s managing director of health policy, said some families even have sought to withdraw their children from the Medi-Cal program because they fear that their immigration status might be shared with immigration officials.

“Holding on to the kids who have recently enrolled is going to become critically important,” Hardy said. She said she hopes families will see that the coverage is a boon to their health and will not be scared away.

In an email last week, the DHCS reiterated to California Healthline that an applicant’s immigration status is “only used for the purposes of determining Medi-Cal eligibility.”

But that doesn’t eliminate the worry for some parents.

“This fear is horrible. We don’t know who to trust,” Luz said.

Before the coverage-for-all law took effect last year, undocumented children could get coverage through the Healthy Kids insurance program in some California counties. However, many of those children have been transferred to Medi-Cal, and the Healthy Kids programs are closing down.

Carlos Jimenez, a health policy advocate at the Mixteco Community Organizing Project in Oxnard, Calif., said the nonprofit doubled its enrollment assistance efforts after the law was implemented.

Community health educators known as promotoras, spread word about the new law in farm fields, in front of supermarkets and outside churches. Last year, enrollment counselors saw up to 400 people a month who had questions about Medi-Cal, the majority looking to enroll their children, Jimenez said.

But after the November presidential election, enrollment counselors at Mixteco saw the number of people seeking help drop by nearly half, Jimenez said. Staffers had expected more inquiries about renewals by now, he said.

Most people ask whether enrolling an undocumented child would bring any problems with the U.S. Immigration and Customs Enforcement agency, Jimenez said. “We tell them their information is safe. But even then, they’re afraid.”

The Children Now survey showed that participants had questions about the future of Medi-Cal for undocumented children — in particular, whether it would continue if the Affordable Care Act were replaced.

In an interview with California Healthline in February, Sen. Ricardo Lara (D-Bell Gardens), who authored the Health for All Kids law, said there was no reason for people to be concerned about the program’s durability.

Democratic Gov. Jerry Brown continues to make this program a priority, Lara said, noting that California is spending $279.5 million to continue benefits for undocumented kids this year. That’s up from the $188 million it provided for the program last year

Health advocates in California are hoping to extend the program to young adults. Earlier this month, the California Immigrant Policy Center and Health Access California, launched an online petition requesting that full Medi-Cal benefits be made available to people ages 19 to 26.

 

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Cuidado con Estafadores Ofreciendo Cobertura Médica Barata

April 20, 2017 by · Leave a Comment 

Mientras el futuro de la cobertura médica continúa siendo un tema de conversación nacional, estafadores están aprovechándose de las preocupaciones sobre los posibles cambios a las leyes de seguro médico.

Una estafa común es cuando el estafador llama a personas al azar y les dice que necesitan nueva cobertura médica debido a cambios recientes en la ley federal. El que llama le pedirá información tal como el número de seguro social, de cuenta bancaria o de seguro médico.

Al conseguir esta información el ladrón entonces puede robarle la identidad a la víctima.

Las siguientes recomendaciones son pasos que puede seguir si llegase a encontrarse en esta situación.

CONSEJOS:

  • No provea su información personal en llamadas no solicitadas
  • Llame a su compañía de seguro médico o a Medicare para verificar si en realidad han habido cambios a su póliza por los cambios en la ley.
  • Reporte estafas de este tipo a la Comisión Federal de Comercio en 877-FTC-HELP

El Desafío de la Salud en Hogares Con Estatus Mixtos

June 9, 2016 by · Leave a Comment 

La residente de Huntington Park Stephanie Martínez tenía sólo cinco años de edad cuando sus padres la trajeron a vivir a EE.UU. como indocumentada. Ahora a sus 23 años, ella es una de las aproximadamente 853.000 personas en el país que tienen un estatus temporal cuasi-legal a través de la Acción Diferida para los Llegados en la Infancia (DACA) promulgada por el presidente Obama en 2012.

También hoy en día ella tiene un seguro de salud, pero al igual que muchos en su situación el camino hacia la cobertura estuvo lleno de obstáculos complicado por el estatus mixto de inmigración de su familia y un ingreso familiar combinado considerado demasiado alto para calificar para los subsidios de salud, pero demasiado bajo para pagar un seguro privado.

Read this article in English: Dreamers in Search of Affordable Health Care

Bajo DACA, los jóvenes entre 16 y 31 años de edad que fueron traídos al país ilegalmente cuando eran niños pueden evitar temporalmente la deportación y trabajar legalmente en EE.UU. siempre y cuando cumplan con ciertos requisitos, como asistir o terminar la preparatoria y pasar una prueba de antecedentes criminales.

Para muchos que han calificado hay un sentido de normalidad, de no vivir más bajo la sombra de la sociedad, a menos que al igual que Stephanie vivan en un hogar de “estatus mixto”, donde algunos miembros de la familia son ciudadanos, residentes legales, o beneficiarios de DACA, pero otros son indocumentados.

Cuando fue promulgada en 2014, la Ley de Asistencia Asequible (ACA)—también conocida como Obamacare—los beneficiarios de DACA, comúnmente conocidos como “soñadores”, y los inmigrantes indocumentados quedaron explícitamente excluidos para comprar cobertura de salud a través de los planes patrocinados por el gobierno ni a recibir créditos tributarios de primas u otros ahorros en el mercado.

“Es política,” dijo a EGP Gabrielle Lessard, abogada de política de salud con el Centro Nacional de Leyes de Inmigración, explicando que la Administración Obama sabía que se enfrentaría a una reacción violenta si se permitiera a los indocumentados y beneficiarios de DACA participar en el programa, pese a que pagan impuestos, los mismos que ayudan con subsidios a la cobertura.

A su corta edad, Stephanie no estaba preocupada por no tener seguro de salud; después de todo, es joven y saludable. Sin embargo, no se podía decir lo mismo de su padre Álvaro Martínez, quien sufre de diabetes y necesita atención médica constante. Él enfrenta una lucha para obtener atención médica asequible debido a su estatus de indocumentado.

La familia Martínez es considerada una familia de estatus mixto donde los padres son indocumentados y los hijos son beneficiarios de DACA. (Cortesía de Stephanie Martínez)

La familia Martínez es considerada una familia de estatus mixto donde los padres son indocumentados y los hijos son beneficiarios de DACA. (Cortesía de Stephanie Martínez)

Así que el año pasado, cuando el padre de Stephanie le pidió que solicitara cobertura de salud para la familia a través del seguro de salud del estado, Covered California, ella aceptó  y llenó la solicitud en una feria de salud patrocinada por AltaMed.

Laura Ochoa coordinadora de mercadeo, trabaja en el programa de AltaMed “Soñadores y Medi-Cal” que revisa si beneficiarios de DACA son elegibles para el programa de Medi-Cal del estado para familias de bajos ingresos, incluyendo a beneficiarios de DACA que pudieran calificar para la cobertura bajo el reconocimiento del estado de individuos que se encuentran residiendo permanentemente en EE.UU. protegidos por la ley de color (PRUCOL por sus siglas en inglés), una categoría de elegibilidad para beneficios públicos creado por los tribunales.

Según los funcionarios de inmigración de EE.UU., “un individuo puede ser elegible para Medicaid (Medi-Cal), si es un extranjero que reside en EE.UU. con el conocimiento y permiso del Servicio de Inmigración y Naturalización (INS) y el INS no contempla exigir la salida del extranjero”, como es el caso de los beneficiarios de DACA.

Los destinatarios de DACA de California y Nueva York cumplen con la norma PRUCOL, dijo Lessard.

Algunos requisitos para calificar para el Medi-Cal de California para los beneficiarios de DACA incluye que tengan un permiso de trabajo válido, un número de seguro social, identificación y prueba de sus ingresos, dijo Ochoa.

Pero el caso de Stephanie era más complicado. Los ingresos combinados de la familia de $46,000 superó el máximo nivel de pobreza federal (FPL) del 138%, o $33.534 al año para una familia de cuatro. Su estado migratorio mixto—sus padres son indocumentados—también hizo que la cobertura de grupo a través del mercado de salud fuera poco probable. El seguro privado es demasiado caro, dijo Stephanie.

Un estudio realizado por el Dream Resource Center del UCLA Labor Center encontró que uno de cada diecisiete niños en EEUU viven en hogares de estatus mixto migratorio.

“Las familias de estatus mixto son un grupo demográfico que crece en Estados Unidos” y su resultado de salud proporciona información sobre el futuro de la salud de la población de EEUU, de acuerdo al estudio “Sin Papeles y Sin Seguro; Un informe de cinco partes sobre jóvenes inmigrantes y la lucha por cuidados de salud en California”.

Stephanie estudia en el Colegio de Santa Mónica y trabaja a tiempo parcial. Dice que es todavía depende de su familia en necesidades básicas como comida y techo.

Según Ochoa, la mejor opción para Stephanie era aplicar como un individuo. Ella dijo que los estudiantes que ganan alrededor de $10.000 podrían calificar para Medi-Cal incluso si sus padres los reclaman como dependientes.

“Si son estudiantes de medio tiempo y trabajadores de medio tiempo, lo más probable es que son elegibles”, agregó.

A principios de este año Stephanie aplicó de nuevo pero esta vez sola y fue aprobada para la cobertura de Medi-Cal mediante L.A. Care Health Plan comenzando el primero de junio.

Stephanie Martinez revisa los documentos que recibió de Medi-Cal (EGP foto por Jacqueline García)

Stephanie Martinez revisa los documentos que recibió de Medi-Cal (EGP foto por Jacqueline García)

Mientras exploraban opciones para la familia, Stephanie también descubrió que el Sr. Martínez califica para la cobertura mediante el programa Capacidad de Pago (ATP) del condado de Los Ángeles, que ofrece servicios de salud asequibles para los residentes del condado de LA que no califican para planes de Medi-Cal, Medicare o Covered California independientemente de su situación migratoria.

El programa es gratis para “individuos con ingresos iguales o menores de $1.367 por mes” y tiene una “[opción] de bajo costo para las personas con ingresos por encima de $1.367 por mes”, como es el caso del Sr. Martínez.

Los solicitantes de ATP sólo pagan por el mes que visitan el hospital o sus clínicas asociadas. Los servicios incluyen visitas al médico y de emergencia, pruebas y medicamentos, explica la página de Internet de Servicios de Salud del Condado de Los Ángeles.

El estudio “Sin Papeles y Sin Seguro”, afirma que la salud de los californianos indocumentados es crucial para el bienestar del estado.

Los investigadores recomiendan expandir ACA a todos los californianos sin importar su estatus migratorio o nivel de ingresos.

“No hay tal cosa como la salud individual; toda la salud es pública y común”, afirma el estudio.

El proyecto de ley SB 10, la exención de la salud para todos, del senador estatal Ricardo Lara, fue recientemente aprobada por los legisladores del estado y podría permitir que los inmigrantes indocumentados compren cobertura de salud a través del mercado de Covered California, pero requeriría primero la aprobación federal.

Martínez le dijo a EGP que ella esta contenta ahora tiene un seguro de salud, pero todavía se preocupa por los problemas de salud de su padre. “Él tiene más necesidad que yo”, dijo.

 

La serie de tres partes fue producida como un proyecto para California Health Journalism Fellowship, un programa del Centro de Periodismo de la Salud de la Escuela de Comunicaciones y Periodismo de USC Annenberg.

 

Para leer Parte 1:  DACA y Obamacare: ¿Quién Califica?

Para leer Parte 3: ¿Vale la pena la SB10? ¿Qué es una exención?

—-

Twitter @jackiereporter

jgarcia@egpnews.com

The Health Challenge In Mixed-Status Homes

June 9, 2016 by · Leave a Comment 

Huntington Park resident Stephanie Martinez was just five years old when her parents brought her illegally to live in the United States. Now 23, she’s one of an estimated 853,000 people in the country who have temporary, quasi-legal status through President Obama’s Deferred Action for Childhood Arrivals (DACA) program enacted in 2012.

Today she has health insurance, but like so many in her situation the road to coverage was filled with obstacles, complicated by her family’s mixed-immigration status and a combined household income slightly too high to qualify for health subsidies but too low to pay for private insurance.

Under DACA, young people between the ages of 16 and 31 who were brought to the country illegally as children can temporarily avoid deportation and work legally in the U.S., provided they meet certain eligibility requirements, such as attending or completing high school and passing a criminal background check.

Lea este artículo en Español: Soñadores en Busca de Cuidado Asequible

For many who have qualified there’s a sense of normalcy, of no longer living in society’s shadow, that is unless like Stephanie you live in a “mixed-status” home, where some members of your family are citizens, legal residents, or DACA recipients, but others are undocumented.

When enacted in 2014, the Affordable Care Act (ACA)—also known as Obamacare—explicitly excluded DACA recipients – often referred to as “dreamers” – and undocumented immigrants from buying health insurance from state or federally sponsored health insurance marketplaces and the premium tax credits, subsidies and other savings on marketplace plans.

“It’s political,” Gabrielle Lessard, a health policy attorney with the National Immigration Law Center told EGP, explaining that the Obama Administration knew it would face a backlash if the undocumented and DACA recipients were allowed to take part in the program, even though they pay into the tax pool that subsides the coverage.

In her early twenties, Stephanie wasn’t worried about not having health insurance; after all, she’s young and healthy. The same couldn’t be said for her father Alvaro Martinez who suffers from diabetes and needs ongoing medical attention, but struggles to get care because he is undocumented.

So last year, when Stephanie’s father asked her to apply for health coverage for the family through the state’s health exchange, Covered California, she gladly filled out the application at a local health fair sponsored by AltaMed.

Marketing Coordinator Laura Ochoa works on AltaMed’s “Dreamers and Medi-Cal” program, which screens DACA recipients for eligibility for the state’s Medi-Cal program for low-income families. DACA recipients can qualify for coverage under the state’s recognition of the Permanently Residing in the United States Under Color of Law (PRUCOL), a public benefits eligibility category created by the courts.

According to US immigration officials, “an individual may be eligible for Medicaid (Medi-Cal), if the individual is an alien residing in the United States with the knowledge and permission of the Immigration and Naturalization Services (INS) and the INS does not contemplate enforcing the alien’s departure,” as in the case of DACA recipients.

California and New York see DACA recipients as having met the PRUCOL standard, Lessard said.

Stephanie Martinez reviews the Medi-Cal documents she received by mail. (EGP photo by Jacqueline Garcia)

Stephanie Martinez reviews the Medi-Cal documents she received by mail. (EGP photo by Jacqueline Garcia)

Requirements to qualify for California Medi-Cal for DACA recipients include having a valid work permit, a social security number, identification and proof they are low-income, Ochoa told EGP.

But Stephanie’s case was more complicated. Her family’s combined household income of $46,000 exceeded the maximum Federal Poverty Level (FPL) of 138%, or $33,534 a year for a family of four to qualify for Medi-Cal. Their mixed-immigration status, her parents are still undocumented, also made group coverage through the health exchange unlikely. Private insurance is too expensive, Stephanie said.

A study by the UCLA Labor Center’s Dream Resource Center found that one in seventeen children in the U.S. live in mixed-immigration status homes.

“Mixed-status families are a growing demographic in the United States” and their health outcome provides insight into the health of the future of the U.S. population, according to “Undocumented and Uninsured; A five part Report on Immigrant Youth and the Struggle to Access Health Care in California.”

Stephanie attends Santa Monica College and works part-time. She says she’s still dependent on her family for necessities like food and the roof over her head.

According to Ochoa, Stephanie’s best option is to apply as an individual. She said students who earn about $10,000 could qualify for Medi-Cal even if their parents claim them as deductions.

“If they are part-time students and part-time workers, most likely they are eligible,” she added.

Earlier this year, Stephanie applied as an individual and was approved for Medi-Cal coverage effective June 1 through the L.A. Care Health Plan.

While exploring her family’s options, Stephanie also discovered that Mr. Martinez qualifies for coverage under Los Angeles County’s Ability to Pay (ATP) program, which offers affordable health services to L.A. county residents who do not qualify for Medi-Cal, Medicare or Covered California plans, regardless of their immigration status.

The program is free to “individuals with incomes at or below $1,367 per month” and has a “low-cost [option] for individuals with incomes above $1,367 per month,” which works for Mr. Martinez.

ATP applicants only pay for the month they visit the hospital or its partner clinics. Services include doctor and ER visits, hospital care, tests and medicines, explains the Health Services of L.A. County website.

The “Undocumented and Uninsured” study states that the health of undocumented Californians is crucial to the wellbeing of the state.

They recommend expanding ACA to all Californians regardless of their immigration status or income level.

“There’s no such thing as individual health; all health is public and communal,” states the study.

A bill by state Sen. Ricardo Lara, SB 10, the Health For All Waiver, recently approved by state lawmakers, could allow undocumented immigrants to buy health coverage through the Covered California online marketplace, but would first require federal approval.

Martinez told EGP she is happy she now has health insurance, but still worries about her father’s ongoing health issues. “He has more need than me,” she said.

Immigrants with one of the following statuses qualify to use the Marketplace:
•Lawful Permanent Resident (LPR/Green Card holder)

•Asylee •Refugee •Battered Spouse, Child and Parent

•Victim of Trafficking and his/her Spouse, Child, Sibling or Parent

•Individual with Non-immigrant Status, includes worker visas and student visas

•Deffered Action Status (Exeption: Deferred Action For Childhood Arrivals -DACA)

[For a full list of eligible statuses visit https://www.healthcare.gov/immigrants/immigration-status/]

 

The three-part series was produced as a project for the California Health Journalism Fellowship, a program of the Center for Health Journalism at the USC Annenberg School for Communication and Journalism.

 

To read Part 1: DACA and Obamacare: Who Qualifies?

To read Part 3: SB10 is it worth it? What is an exemption?

—-

Twitter @jackiereporter

jgarcia@egpnews.com

Dreamers In Search of Affordable Health Care

June 2, 2016 by · Leave a Comment 

June 15, 2012 was a historic day for thousands of young immigrants who under President Obama’s executive action became eligible for temporary relief from deportation.

“These are young people who study in our schools … they pledge allegiance to our flag. They are Americans in their heart, in their minds, in every single way but one: on paper,” said Obama when he introduced Deferred Action for Childhood Arrivals (DACA), a program making nearly 1.5 million youth brought to the country illegally as children eligible for a reprieve from deportation and a work permit, both renewable every two years.

Lea este artículo en Español: Soñadores en Busca de Cuidado de Salud Asequible

Over 853,000 immigrants between the ages of 16 and 31, often referred to as “dreamers,” have applied for DACA status since the president’s announcement. For many, with the ability to work legally came the hope of higher wages and perhaps benefits.

Getting health insurance, however, has not been easy for some. For others, it’s not a priority.

The Affordable Care Act (ACA) enacted in 2014—commonly known as Obamacare— excluded DACA recipients from coverage because they are not permanent legal U.S. residents or citizens.

In this three-part series, EGP looks at some of the challenges this group of dreamers face in their search for affordable health care and the options they have to access services.

 

DACA and Obamacare: Who Qualifies?
Los Angeles resident Nidia Torres was brought illegally to the U.S. when she was six years old. She lived in the shadows for over two decades, hoping not to be discovered or deported back to Mexico, a country she does not call home.

In 2013, everything changed. Torres was granted DACA status and excitedly started planning for the future. The opportunities a work permit, driver’s license and social security number would bring to her life were endless, including providing a better future for her U.S. born daughter, Torres told EGP.

“No more shame for being undocumented,” she recalls thinking when her work permit arrived in the mail.

Nidia Torres, 34 with her four-year old daughter said DACA has provided her great opportunities, in this country, which she consider home. She just needs to find an option for medical insurance. (Courtesy of Nidia Torres)

Nidia Torres, 34 with her four-year old daughter said DACA has provided her great opportunities, in this country, which she considers home. She just needs to find an option for medical insurance. (Courtesy of Nidia Torres)

Torres soon landed a job waitressing at a national restaurant chain where she was paid minimum wage plus tips, but did not offer health insurance.

“I can work legally, my daughter has Medi-Cal, so I think I’m OK,” she told EGP, explaining that after years of low-paying jobs and long hours that left her little time for her daughter, the new job was a big step forward.

“I just wanted a job,” she told EGP. “Plus I don’t really get sick,” so health insurance was not a big deal, she said, adding she had no idea where to get coverage on her own.

Torres, who speaks both English and Spanish and has some college education has since been promoted to manager and is earning more money, but still has no health benefits.

The goal of the Affordable Care Act was to increase “the quality, availability, and affordability” of private and public health insurance to the then over 44 million uninsured Americans, providing they are legal permanent residents or U.S. citizens. To keep costs down, large numbers of young, healthy individuals — the same group targeted by DACA — would have to be enrolled, yet undocumented immigrants and DACA recipients are ineligible to buy health coverage through government sponsored health exchanges or receive premium tax credits or other savings on marketplace plans, even though they pay into the tax system.

Gabrielle Lessard, a health policy attorney with the National Immigration Law Center, calls the policy unjust. DACA recipients are working and paying taxes for a service that they can’t apply for, she told EGP.

“The exclusion of DACA recipients probably increases the price of insurance for all other people,” Lessard said.

In California, however, some low-income undocumented immigrants and DACA recipients may qualify for Medi-Cal, a state funded health insurance program for low-income families, people with disabilities, pregnant women, children in foster care and low-income adults who meet certain requirements.

(DHHS)

(CDHCS)

Torres is not one of them. According to the California Department of Health Care Services and federal eligibility requirements, Torres’ $23,000 a year income puts her just slightly above the $22,108 maximum Federal Poverty Level (FLP) for a family of two, making her ineligible for Medi-Cal.

Like many other DACA recipients with incomes “too high” for health insurance subsidies, Torres’ options for health coverage are limited, and the process for finding affordable coverage can be complex, according to the UC Berkley study, “Realizing the Dream for Californians Eligible for Deferred Action for Childhood Arrivals: Health Needs and Access to Health Care.”

Many DACA recipients don’t even know they have options, the study found. The lack of information reflects “the complexity” of the network of programs available and the process to access them, researchers stated.

Getting health care doesn’t have to be a problem, says Irene Holguin, director of community relations with Arroyo Vista Family Center, a network of five clinics serving the east and northeast side of Los Angeles.

During a free family health fair Friday at Arroyo Vista’s clinic in Lincoln Heights, Holguin told EGP there are options for everyone, regardless of immigration status or income.

When people arrive at one of our clinics for the first time they undergo a financial screening to determine what types of programs they are eligible for, she said. “We don’t turn anyone away,” she added. She explained that the clinic offers discount programs and fees to those who not qualify for state or federal funded program.

For example, if a patient can only pay $10, Arroyo Vista will help them set up an affordable payment plan for the balance, Holguin said.
The Arroyo Vista clinics provide primary health care in communities where approximately 98% of families are Latino and many of them low-income, explained Holguin.

“There’s a lot [more] that needs to be done in regard to informing the community and encouraging people to be proactive and seek preventive health services,” she said, “because a lot of people have illnesses that they don’t even know they have.”

As for Torres, she told EGP she would be open to going to a clinic like Arroyo Vista to look into her what her options are. “Better safe than sorry,” she said.

 

The three-part series was produced as a project for the California Health Journalism Fellowship, a program of the Center for Health Journalism at the USC Annenberg School for Communication and Journalism.

 

To read Part 2: The Health Challenge In Mixed-Status Homes

To read Part 3: SB10 is it worth it? What is an exemption?

—-

Twitter @jackiereporter

jgarcia@egpnews.com

Menores Indocumentados en California se Benefician por Medi-Cal

May 19, 2016 by · Leave a Comment 

Más de doscientos mil menores indocumentados que residen en California se verán beneficiados por el seguro de salud estatal Medi-Cal.
La medida que entró en vigencia el lunes, promovida por el senador estatal, el demócrata Ricardo Lara, convierte al estado en el proveedor más grande en otorgar cobertura gratuita a los niños inmigrantes en todo el país.

“En este momento que hay tanta persecución contra nosotros, (indocumentados) esta ayuda nos hace sentir que no todos nos están rechazando, que hacemos parte del estado”, manifestó a Efe María Sandoval, de 34 años, que no quiso decir su nacionalidad.

La inmigrante tiene una hija de 14 años, que llegó hace poco al país y aunque la pequeña había recibido todas sus vacunas en su país de origen, tuvo que tomar nuevamente las dosis.

“Eso fue un problema, no me la quisieron atender porque no tenía el Medi-Cal, y eso que sólo eran unas vacunas”, explicó Sandoval.
La ley Salud para Todos amplió la cobertura del Medi-Cal a los indocumentados menores de 19 años cuyas familias tengan un ingreso igual o inferior al 266 por ciento del nivel federal de pobreza.
Por ejemplo, un niño en una familia de cuatro personas califica al seguro médico si el ingreso de la familia es igual o inferior a 64.638 dólares al año.

El seguro estatal de salud de California, Medi-Cal, está cumpliendo 50 años de existencia.
El gobernador Jerry Brown dijo que la expansión y la adición de fondos en el seguro para favorecer a los niños inmigrantes es una forma de reconocer el aporte de todos los residentes del estado.

“Hoy se celebra otro hito mediante la ampliación de los servicios a los niños, sin importar su estatus migratorio”, remarcó Brown.
Tanto el gobierno de California como los activistas han desarrollado una campaña para registrar a los menores en Medi-Cal, que estará disponible todo el año.

Los padres pueden solicitar el servicio por teléfono, en línea, o por correo en la oficina de Servicios Humanos del condado local, así como en cualquier clínica comunitaria local.

“Las familias también tienen la opción de acudir a un agente certificado de Covered California o llamar al centro de servicio en español donde serán dirigidos al programa o plan que responda a sus necesidades”, dijo Yurina Melara, portavoz de Covered California.

Según Sandra Rossato, directora ejecutiva de la Clínica Monseñor Oscar A. Romero en Los Ángeles, la respuesta de las familias ha sido positiva. No obstante, advirtió que “saben que muchos padres tienen temor de inscribir a sus hijos por su estatus migratorio”.

Parte del esfuerzo se ha enfocado en educar a las familias en que la información que se da es privada y los proveedores no pueden compartir esa información con nadie más que el estado.

“Yo he estado pasando la voz y haciendo llamadas para que entendamos cuales son los derechos de nuestro hijos con esta medida, porque debemos aprovechar de esta oportunidad”, insistió Sandoval, líder comunitaria y miembro del sindicato SEIU-United Healthcare Workers West.
Para Adriana Sánchez, una madre de cinco hijos, dos de ellos ciudadanos estadounidenses, la noticia es un alivio para su familia que veía dividida por el servicio de salud que recibían.

No obstante, agregó, incluso con el seguro los fondos no alcanzan para poder dar la asistencia de calidad y a tiempo.

“Aun me preocupa que ellos tres van a sufrir igual que mis otros dos hijos por la falta de servicios a personas con Medi-Cal, ya que se nos niega el servicio y la espera es muy larga, y las citas a especialistas son muy lejos”, advirtió.
El senador Ricardo Lara, promotor de la ley, está consciente de los problemas de acceso y por eso está trabajando en dos proyectos de ley que permitirán más recursos y más oportunidades para los indocumentados.

Con la medida SB10, actualmente en trámite en la Asamblea, California otorgaría una exención federal que permitiría a los inmigrantes indocumentados comprar planes de salud subsidiados por Covered California.

La iniciativa SB1418, pendiente en el Senado, extendería la elegibilidad para beneficios completos de Medi-Cal a todos los residentes mayores de 19 años, sin importar su estatus migratorio.
De aprobarse, California sería el primer estado en la nación en otorgar esta clase de servicios.

Padres de Niños Indocumentados en California Podrán Inscribirse a Medi-Cal

April 21, 2016 by · Leave a Comment 

Organizaciones de California trabajan para que los padres de los miles de niños indocumentados que residen en California aprovechen desde el 16 de mayo próximo su derecho a recibir servicios médicos gratuitos sin temor de tener problemas con Inmigración.

“Estamos incentivando a los padres y madres para que desde ya se acerquen a las clínicas comunitarias y realicen la inscripción. Estamos tratando de llevar incluso esta información a las escuelas”, dijo a Efe la vocera del sindicato SEIU-United Healthcare Workers West, Hortencia Armendariz.

Al menos 250.000 inmigrantes menores de 19 años y de bajos recursos calificarían para obtener los beneficios completos de Medi-Cal, de los cuales unos 115.000 ya tienen cobertura pero para emergencias.

“Ahora ellos no tendrán restricciones en los servicios y podrán continuar con el seguimiento y los tratamientos médicos que necesitan”, advirtió Armendaríz.
La noticia llega como un bálsamo para los padres de estos pequeños, como Evangelina Hernández, una trabajadora del campo de Tracy, California.

“Por muchos años fue muy difícil llevar a mi niña al doctor, no había dónde la aceptaban porque ella no es nacida aquí. Me preocupaba bastante, pidiéndole a Dios, que no se enfermara”, relató a Efe.

Ante los altos costos para llevar a su hija a un médico particular, Hernández por casi una década tuvo que recurrir a darle a la pequeña remedios caseros e incluso pedir prestado para sus vacunas. Ahora la menor tiene 15 años y podrá ir al médico familiar y especialistas.

Además de la atención médica, los beneficiados obtendrán exámenes de la vista, cuidado dental, tratamiento de abuso de sustancias y servicios de salud mental que están disponibles bajo Medi-Cal.

Para calificar los padres del menor deben llenar la solicitud, mostrar una prueba de identidad y residencia en California, además de otros documentos que demuestren sus ingresos, que deben estar por debajo del 266% del nivel de pobreza federal (64.638 dólares al año para una familia de cuatro miembros).

La ley SB4, que autoriza la extensión del Medi-Cal a los menores indocumentados, incluye una inversión de 40 millones de dólares para expandir la cobertura.

California se convierte así en el primer estado del país en extender este beneficio a los indocumentados.
”No pueden perder la oportunidad de recibir este servicio, queremos resaltar que esta información no se comparte con las autoridades federales de inmigración”, insistió Armendariz.

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