LONG BEACH, CA—Two years ago, sisters Alejandra, 10, and Vanessa, 12, were still in Ahuachapán, El Salvador, with a father they describe as neglectful and grandparents who were too old to offer much care. Living in a neighborhood run by gangs and surrounded by bars and nightclubs, the sisters say they lived in daily fear of the drug deals and violent robberies happening all around them.
So in 2014 they left, part of a growing wave of children fleeing violence in Central America. The pair traveled almost 3,000 miles across multiple borders, alone, to reunite with their mother Martha, who they hadn’t seen in three years.
California brought a better life, but it didn’t come without challenges.
Before today, the best way Martha could treat Alejandra’s chronic stomach issues was with a mixture of cornstarch, water and lime—a home remedy from El Salvador. For Vanessa, eye exams and much needed trips to the dentist were out of the question. If things ever got really bad for the girls, there was always the emergency room.
It's not that the emergency room isn't there anymore, but now they have better access to health care.
Alejandra and Vanessa are among the 170,000 undocumented minors in California who today became eligible for low-cost medical, vision, dental, and mental health services under Medi-Cal, California’s version of the federal Medicaid program.
The health care expansion, known as Health4All Kids, was signed into law last year by Gov. Jerry Brown and provides comprehensive, low-cost care to all low-income youths 19 and under in California, regardless of legal status.
California is now the fifth and largest state to extend low-cost healthcare to undocumented minors, joining Massachusetts, New York, Washington and Washington D.C.
Martha, who is also undocumented and asked that her full name not be used, couldn’t be happier. Until now, only her husband and youngest daughter, both legal residents, had health insurance.
“For people (like us) who earn minimum wage, how were we going to pay for rent, food, and our children’s healthcare?” said Martha, who works as a cook. “To pay for one thing, you have to ignore another.”
When Martha’s daughters arrived in the U.S. they promptly filed applications for asylum, but like the vast majority of Central American asylum seekers, their requests were denied.
“We were devastated,” recalled Martha, “but we couldn’t give up.”
The girls subsequently applied for Special Immigrant Juvenile Status (SIJS), a permanent residency program for children who have been abused or neglected in their home country. They hope to have an answer by the end of May.
The legal process has been expensive, said Martha, another reason she’s thankful to now have low-cost health care available to her daughters.
Enrolling all of the 170,000 eligible undocumented minors, however, won’t be easy, according to Mayra Yoana Jaimes Peqa, a researcher at the UCLA Labor Center.
“Southern California as a whole looks very different than Central California, where you have more migrant workers,” who may not speak or read Spanish, said Peqa. Although indigenous languages like Mixteco and Triqui are now common in the Central Valley, she said, they're not likely to be translated onto brochures or outreach materials for programs like Medi-Cal.
Getting the word out to undocumented Asian and Pacific Islanders (API) has been equally tough.
“They believe they are not eligible or that this is only for Latinos,” said Betzabel Estudillo, a health policy coordinator at California Immigrant Policy Center (CIPC), which has translated flyers into various API languages and organized resource fairs specifically targeting API populations.
In Los Angeles, schools have struggled to inform families because of limited budgets.
“They’re asking us to come up with our own flyers and that’s an issue because our schools don’t have money for paper and ink,” said Claudia Carolina Hernandez, an enrollment coordinator with Healthy Start who is working with several schools in L.A.
Despite the challenges, Hernandez has a calendar full of appointments to enroll families.
“I found out very quickly that when these families feel they can trust me, then they will give me access to their child’s information,” Hernandez said. “Most of the time, families that I see were recommended by someone they know.”
Undocumented families may avoid enrolling their children in Medi-Cal out of fear that their personal information will be shared with immigration authorities. Estudillo said that fear is unfounded.
“We want families to know that Medi-Cal will not be sharing any personal information for anything other than eligibility,” she said.
Nevertheless, those fears are likely to increase in the coming days, with a 30-day surge in immigration raids and deportations set to begin this month.
Martha understands the fear all too well. “What if I leave for work and don’t come back? What if my daughters’ court proceedings end in their deportation? We live with those fears.”
With child enrollment underway, proponents of the current expansion are already working on next steps.
Sen. Ricardo Lara (D-Bell Gardens), who authored the legislation that created Health4All Kids, is currently pushing another bill, SB 10, that would allow undocumented adults in California to purchase health insurance through the marketplace created by the Affordable Care Act.
“At the end of the day, we all have a heart beating, an immune system, and cells that make us identical to other individuals who may have different political viewpoints than we do,” said Peqa. “We all get sick. And we all, regardless of our politics, should have access to health care.”
For information on how to enroll in Medi-Cal, click here.
For answers to frequently asked questions about Medi-Cal for undocumented children, click here.
This content was made possible by a grant from The California Endowment and produced independently by Fusion’s Rise Up: Be Heard Journalism Fellowship.
Betty Marquez will be exploring issues of environmental racism in southeast Los Angeles and its effects on the area's residents. Having been raised in Bell, California with little access to the outdoors, she is passionate about claiming space for women of color through her hiking, backpacking, and traveling adventures. She is currently a teaching assistant at an elementary school where she interacts with brilliant first graders on a daily basis. Betty holds a degree in feminist studies from UC Santa Barbara.