COMMENTARY: While state budget extends health benefits for undocumented young adults, we’re still fighting for #Health4All

July 3, 2019 /


In my work at Visión y Compromiso, an organization dedicated to advancing the work of Promotoras and Community Health Workers (CHWs), I’m reminded every day of why we need universal health coverage for all residents, regardless of age or immigration status. Promotoras and CHWs play an important role in informing community residents about health care resources, how to make good decisions about nutrition and exercise, and in promoting behavior changes that can help them lead healthier lives.

In my home county of Kern, more than 61,000 people remain uninsured even after the implementation of the Affordable Care Act (ACA). Our neighbors, our co-workers and our friends are left without regular access to care.  They experience delays in getting medication, postpone needed care, and have higher rates of undiagnosed conditions. Those who have chronic conditions are left to self-manage or to use free health events that aren’t intended to help manage conditions instead of visiting a care provider who has complete access to the patient’s medical history. 

Immigration status is the most prevalent reason for lack of coverage among the state’s approximately 2.9 million uninsured, according to the California Health Care Foundation. More than 90 percent of undocumented adults — or 41,000 Kern County residents — are uninsured. Though these county residents grow and prepare our food, build and maintain our homes, and care for our loved ones, they are left without preventative services and regular health screenings.

Two weeks ago our state Legislature passed a budget that expanded Medi-Cal to cover young undocumented adults between the ages 19 to 26 — children are already covered.  Governor Gavin Newsom has expressed support for expanding care for this segment of the population, but he has argued that expanding coverage for undocumented Californians who are older than 25 would overwhelm the system as the economy slows.

Care must be provided based on need, not based on immigration status or age. At a time when the Trump administration has focused on cruel enforcement measures and restricting immigration, some members of our community are afraid to access services that they are eligible for because of the proposed changes to the public charge rule. Trump’s proposed public charge rule would punish immigrants who do not yet have permanent status from seeking certain public assistance. California is poised to act boldly in response to these anti-immigrant policies by expanding care to this vulnerable population.

Expanding #Health4All in our state would improve the health of these adults, a majority of whom work and live in families with children. While the state has expanded care to undocumented children through Medi-Cal since 2016, we can take a bold step to ensuring that all members of immigrant families, regardless of status, are able to access care and lead more healthy lives.

It is my hope that our leaders in the legislature continue to advocate to expand health care as widely as possible in our state. Nobody should rely on a patchwork of health services while living in the 5th largest economy in the world.

Nataly Santamaria is the Kern County Promotora Network Manager for Vision y Compromiso and a member of the #Health4Kern collaborative.