Juliana Barbassa, AP, March 15, 2009
Graciela Barrios, an undocumented immigrant, has long relied on her Sacramento County health clinic for the advice, medication and tests that keep her diabetes under control.
But next month, Barrios and thousands like her will be on their own as communities cut non-emergency health services to illegal immigrants and more local governments are forced to make similar decisions. Nearby Contra Costa County will vote Tuesday on whether to cut services to the 5,000 illegal immigrants they serve each year.
Data on health care for unauthorized immigrants is hard to come by, because community clinics and hospitals usually do not ask patients for their immigration status. But the Pew Hispanic Center estimates that of the 11.9 million illegal immigrants living in the United States, about 59 percent have no health insurance. That accounts for about 15 percent of the nation’s approximately 47 million uninsured.
More than half of local health departments across the country laid off or lost employees in 2008, according to a survey in January by the health officials association. About one-third predicted layoffs in 2009.
In Sacramento County, such cuts at first meant closing three of six clinics. In February, with less money and more patients, county supervisors and health officials had to decide: close one more clinic–laying off up to 40 staffers to save $2.4 million–or cut services to the approximately 4,000 illegal immigrants treated annually.
Contra Costa County officials are doing the same hard math: if they vote to cut services, they will save about $6 million.
After letting go of social workers, cutting mental health services and watching a delivery room built to handle 120 births a month accommodate 240, there were few other options, said Contra Costa Health Services Director William Walker.
Counties may legally cut services to illegal immigrants. Although hospitals receiving Medicaid funds must provide emergency care for anyone who needs it, there is no law requiring health care providers to offer primary care.