Oregon legislators hope to tackle issue

Guadalupe Romero Munoz’s father, Nicholas, first complained of a blister on the heel of his right foot in December. In January, when the bladder continued to grow, Munoz took his father to a local emergency clinic. The clinic asked the family to take Nicholas to a specialist instead.

However, since his father has no papers and is not allowed to enroll on the Oregon Health Plan, the family could not do so. With no access to health insurance and care, the infection in Nicholas’ foot worsened.

The family bonded with a social worker in April who helped them meet with a specialist on June 1 and apply for financial help. The doctor said the infection went too far to treat.

Munoz’s father is now in the hospital waiting for an operation to amputate his foot.

“The doctors did everything they could to save his foot, but with so much damage it was impossible,” said Munoz. “Without an amputation, he will lose his life. It is devastating and unjust. If he had access to insurance, he would not have lost his foot. “

The story of Munoz and his family resembles stories of hundreds of other undocumented families in Oregon and the United States.

Stakeholders are urging the legislature to change these histories by passing law that extends Medicaid entitlement to all adult Oregonians who would qualify for the Oregon Health Plan without their immigrant status.

MP Wlnsvey Campos, D-Aloha, a main sponsor of the bill, said it could be a landmark law.

Only six states, including Oregon, currently offer eligible undocumented children Medicaid coverage. California extended this coverage to undocumented young adults under the age of 25 in 2019.

In January, Illinois became the first state to extend Medicaid coverage to undocumented seniors. California could soon become the second.

However, HB 3352 would remove these age restrictions.

“You don’t just become a senior and suddenly you have health problems,” said Campos. “Why wait until someone gets to a place in time that it may be too late to deal with these health issues?”

Without papers, uninsured

According to the Oregon Health Authority, 94% of Oregon residents had health insurance in 2019. Of the 6% of Oregon uninsured, 12% were Latinos – the highest of any ethnic minority.

A large portion of the estimated 140,000 undocumented adults in Oregon are among the state’s uninsured people, often employed in industries with no health plans and excluded from the Oregon Health Plan.

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Oregon immigrants aren’t the only ones facing this challenge.

In the United States, 23% of legal immigrants and 45% of undocumented immigrants compared to 9% of citizens were uninsured, according to a 2018 analysis by the Kaiser Family Foundation of the American Community Survey.

According to US census data, 71% of undocumented adults had no insurance.

Efforts to expand coverage

Legislators are hoping to change that in Oregon with HB 3352 A, or Cover All People.

The bill would expand and rename the 2017 Cover All Kids legislation, which resulted in state health insurance for an estimated 17,000 undocumented children in Oregon.

The Oregon Health Authority reported that 1,127 people within the Cover All Kids population received OHP registration assistance within the first 12 months. By the end of 2019, almost 5,900 children were enrolled.

The proposed measure currently includes $ 100 million from the General Fund to extend OHP eligibility to adults who would qualify for the program but have their immigrant status.

The full impact and cost of participating in the undocumented adult program is difficult to accurately predict, according to the tax impact report of the measure. This is due to the inability to accurately predict the eligible population and the number of people who would choose to have coverage.

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The report adds that while the OHA will seek state exemptions to offset the cost of providing medical assistance to adults under the Cover All People program, the program’s target audience in general: not eligible for federal reconciliation.

Supporters of the effort said the state also incurs unpredictable savings when individuals receive preventive health care in a doctor’s office or clinic instead of emergency hospital care.

MEP Teresa Alonso León, D-Woodburn, was a freshman campaigning for Cover All Kids legislation.

She said the bill was “the least we could do”. She is now one of the main sponsors of Cover All People.

It’s a bill that strikes near home.

Formerly undocumented, she remembers her own family who grew up without health insurance. She becomes emotional remembering her mother using the home remedies she learned from Leon’s great-grandmother who was a midwife, and witnessing her parents sacrificing doctor visits to care for their five children.

“My mother would try to heal herself before considering seeing a doctor,” León said.

“As a young person, I wrote the checks on their bills so I knew if they had money or not. And I knew my parents would refuse to see the doctor because they couldn’t afford it, ”added León. “Of course, if the situation got bad, they did, but I also knew that when they got those medical bills they had this heavy burden that they had to carry because there were many things they couldn’t afford.”

Olivia Quiroz, executive director of the Oregon Latino Health Coalition, said the nonprofit’s work to pass Cover All Kids had “cemented the needs for access to health care for our working families falling through the cracks of our health system.” .

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In 2009, a report by the Pew Research Center found that 41% of hispanics without citizenship and without legal permanent residence relied on community clinics or health centers for health care. These centers are primarily designed as ‘safety nets’ for vulnerable populations and are funded from a variety of sources, the report added.

That is still the case in Oregon, Quiroz said.

The organization helps connect people to any community health clinic that is open on a walk-in or sliding fee scale, she said.

“This is how they are taken care of, but to really reduce these loopholes, this bill comes into play,” said Quiroz.

Another sponsor of the bill, Rep. Lisa Reynolds, D-Portland, said HB 3352 would ensure the state looked into Oregonian health care before they become expensive and life-threatening.

Studies have shown that across the country, people without insurance are less likely to receive benefits for serious health problems and chronic illnesses.

According to a letter from the Kaiser Family Foundation, a survey found that 41.5% of uninsured adults said they had not seen a doctor or health care professional in the past year. And 30.2% of uninsured adults said they missed out on long-term care costs in the past year, a much larger percentage compared to 5.3% of adults with private insurance and 9.5% of adults with statutory health insurance .

“I just know it’s the right thing,” Reynolds said of Cover All People. “That saves money in the long run, but it is also right.”

The effects of the pandemic

Laws to expand Medicaid to undocumented Oregonians have been talked about for years, said Rep. Andrea Salinas, D-Lake Oswego, but the COVID-19 pandemic has highlighted the need to address health inequalities.

“We just made these patchwork pieces,” she said. “We knew we weren’t doing everything we should be doing. And when the state got this ARPA money and we knew we were better off [fiscally] when we thought this year, we thought, ‘We have to take advantage of that.’ Especially when we knew our Latinx and color communities weren’t doing so well during the pandemic. “

Sponsors and proponents of the bill similarly refer to the pandemic as a clear indication of the lack of health care facing a significant segment of Oregon’s population.

Latinos and other color communities are disproportionately affected by COVID-19. Hispanic or Latino people are twice more likely to be infected with the virus and 2.3 times more likely to die from COVID-19, according to the CDC.

In Salina’s Lake Oswego district, which is 80% white, the first confirmed case of COVID-19 was a Hillsboro Hispanic administrator. That case, weeks before a global pandemic was declared, made it clear to Salinas that the pandemic would soon hit her differently.

During her testimony on HB 3352, Salinas said that immigrants are a significant part of the workforce. They also work on the front lines in industries that stayed open during the pandemic. The bill, she believes, is a way to return the care to them.

“You can’t tell people to keep working without health care and safety nets,” said Salinas. “The pandemic has made people realize that our Latinx and undocumented workers are fully thriving members of our community. Why do we exclude them from certain programs that actually help them continue to be full members of our community and workforce? “

Reynolds called the pandemic “a crucial moment when we really understand how our health is connected without neighbors”.

“I hope we have the courage to do the right thing,” she said. “Oregon has a proud history of pioneering healthcare in so many things. I think this is another area where we can pioneer and show how we can do this and lead the way for other states.”

The bill had stalled for weeks in the Joint Committee on Means and Ways.

A working session was held on Monday and the legislature passed the change to allow the OHA to limit eligibility to certain groups of people if necessary. This is to ensure that the state can meet the $ 100 million allocated to the program for the biennium beginning July 1, 2021.

HB 3352 will now return to the full committee for review and will require both House and Senate approval before the session is suspended at the end of the week.

Dianne Lugo is a reporter for the Statesman Journal for Justice and Social Justice. You can reach her at dlugo@statesmanjournal.com, 503-936-4811 or on Twitter @DianneLugo.

source https://dailyhealthynews.ca/oregon-legislators-hope-to-tackle-issue/