by Agustin Durán. To read the original Spanish-language article in La Opinión, click here. (Para leer este artículo en español, haga clic aquí.)

Undocumented immigrant Estela García, age 84. (Photo: Agustín Durán/La Opinión)

Estela García is not intimidated. She walks a lot, eats as healthfully as possible and stays positive. In general, this is the recipe that has allowed her, at the age of 84, to stay healthy. As an undocumented immigrant, living in the midst of one of the world’s most frightening pandemics, self-care and a positive outlook are what keeps her going.

“I just don’t panic,” she emphasized, but I don’t watch television either.” : “The news exaggerates so much that people believe everything and do not reflect on the veracity of what they hear or see.”

An immigrant from Etzatlán, Jalisco, Mexico, since 2006, García visits free health fairs to get exams that keep her calm and fit. Of course, there is not one day that she does not constantly repeat to herself: “I’m not going to get sick. I’m not going to get sick; I am healthy.”

García remembers the last time she got sick was three years ago when she almost passed out; she was depressed and very weak. The same day, a friend took her to a clinic in Torrance, near Los Angeles, where she was treated through MediCal’s emergency program. Since then she has not stepped foot in a hospital.

She adds that the clinic sent her a bill for approximately $3,000-$5,000, which she could not pay. She contacted a social worker, and months later the provider stopped sending her bills. “I did want to pay, but I told them that because of my age no one would give me a job and I have no family here,” she told them. “I offered to pay them with volunteer work, but I think they didn’t want to and they just stopped billing me.”

Although, Garcia does not have Social Security, a retirement account, pension or any other government income; however, she calmly explains that she has great faith in her optimistic philosophy. For example, friend provides her shelter and food in exchange for cleaning and caring for her son, who has a mental disability, so she says she’s is doing well.

Currently, throughout California, people are asked not to go out and risk spreading the coronavirus pandemic, but Garcia says she simply does what she has to do. “The police stopped me twice and asked me where I was going,” she explained. “I told them I was going to buy food, but they insisted there are programs that deliver for free. I said no, I like to walk and they just laughed.”

García said that on several occasions she has gone to community clinics to be examined, but they wanted to charge her a modest fee. Having no money, though, she did not return.

Of the 2.2 million undocumented people living in California, an estimated 2% are age 65 or older, according to a University of California, Berkeley, Labor Center report. And University of Texas, Austin, sociologist Jacqueline L. Angel, said not having health insurance in the United States in the midst of the COVID-19 crisis is a critical problem for keeping immigrant families healthy.

“Having coverage brings health security, reducing stress associated with fears about the virus spreading across the nation,” Angel said. “Many immigrant workers have lost their jobs and are struggling to make ends meet; a catastrophic event, such as a hospitalization of a family member, accentuates financial strain.” She added, “Health insurance protects insured Americans from unexpected, high medical costs; and without critical benefits immigrant families are at heightened risk of death and despair.”

Denny Chan, an attorney with the nonprofit Justice in Aging, said the immigrant community, documented or not, is experiencing situations that are complicated by anti-immigrant policies of the Trump administration.

He emphasizes that the administration’s “public charge” rule, threatening to deny permanent status even to people holding a green card if they use any low-income benefits, there is a lot of confusion. Many prefer not to apply for health benefits due to possible repercussions when they try to secure their status as a legal resident.

Chan stressed that, in the absence of health insurance, immigrants who are not yet citizens or are undocumented rely more on community or nonprofit clinics, although services are more limited and those locations tend to be more crowded.

One service is the Romero Clinic, which serves approximately 60,000 people annually in two locations, 95% of them immigrants and 40% undocumented. Clinic Executive Director Carlos Vaquerano explained that currently services provided to people without documents are limited. Although free or low-cost programs can help them, such as Sliding Fee or MyHealthLA, generally people without documents wait until the last minute to get treated.

He added that people want to avoid any out-of-pocket expenses or to be a burden for their family, but that makes the situation more complicated because in many situations they end up in emergency rooms and in grave conditions.

“There are people who don’t come to the clinic until they are very ill, complicating the chances of recovery,” Vaquerano explained. “That’s when the doctor comes and sees them and immediately sends them to the hospital emergency room.”

One great advantages of community clinics in Los Angeles is that many of their staff members speak a patient’s language and understands the person’s native culture, such as the diet and lifestyle. That is why so many people have confidence in them, he said. Vaquerano indicated that the majority of the patients at the Romero Clinics are Mexican, Central American, ands some are Asian and African American.

He added that the fact that Latinos are more attached to family helps a lot, particularly for elders because they are not placed in nursing homes, which influences their health.

In the midst of the COVID-19 pandemic, the clinic has changed its procedures. Patients who arrive there get their temperature taken and are examined to make sure they does not have symptoms of the coronavirus. The clinic sends those who so to a hospital immediately. In addition, a phone system has just been implemented enabling people to not have leave their home to talk to a doctor.

At the beginning of the year, Gov. Gavin Newsom submitted a budget that would expand MediCal to provide care for undocumented elders. If approved by legislation, on January 1, 2021, thes seniors would have access to health insurance. Vaquerano indicated that this measure would help one of the state’s most vulnerable groups. In the extension’s first year, MediCal could insure at least 27,000 undocumented seniors.

Regarding the governor’s decision, State Senator María Elena Durazo (District 24), who proposed the measure last year, said it would help prevent conditions from worsening to the point where seniors end up in the emergency room.

“We believe that the health system to be effective must include all Californians,” said Durazo. “That way, you will have better control over prices and quality. We cannot have the best health system if we exclude two million people from the health system”, referring to all undocumented immigrants.

The Mexican Consulate, an Option

Elena Aragón, director of the health window of the Mexican Consulate in Los Angeles, said the program serves an average of a thousand people each month. In addition, another 500 people come to the monthly health fair that the consulate holds with other organizations. Of those who receive information or treatment at the health window or fair, only 10% are elders and possibly half do not have U.S. documents. For many of them, the window or fair are the only sources for  health care assistance. Aragon explained that if patients need treatment or have serious issues, they are referred to community clinics or non-profit medical centers.

Although the United States government enacted its economic stimulus, which will  in which send most family members $1,200, it will not come to people without documents, even if they have been paying taxes with their ITIN number.

Agustin Durán, Metro Editor of La Opinión in Los Angeles, wrote this article in Spanish and also translated it into English with the support of a journalism fellowship from The Gerontological Society of America, Journalists Network on Generations and the Silver Century Foundation.

The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.