Patricia Presa will seek treatment for her uterine cancer in Mexico. (Photos: Valeria Fernández)
PHOENIX, Arizona — A month ago, Patricia Presa learned that she has uterine cancer. She’s decided to go back to her native Mexico to seek treatment there, because she is an undocumented immigrant and can’t afford to pay for health care in the U.S.
“Unfortunately, I need the treatment but I don’t have the money to pay for the expenses. Whether it is the medicine or the doctor’s appointments, each costs me $110,” said Presa, who’s 33. She doesn’t know if the care she’ll receive in Mexico will be better than what’s available in Arizona, but she hopes she can apply for a form of public insurance the country offers to residents known as Seguro Popular. She is married to a U.S. citizen, but because she came across the border illegally she is ineligible to adjust her immigration status or receive health care benefits in the U.S.
Listen to Presa (in Spanish):
[audio:http://feet2worlds.centernyc.org/Patricia.mp3]
The decision by Presa and other unauthorized migrants to return to their home country for medical treatment is further evidence of the link between two hotly contested issues facing Congress and the Obama administration — health care reform and immigration. The ability of undocumented immigrants to access health care services under President Obama’s reform package has stirred controversy and criticism from both ends of the political spectrum. But for the most part, the undocumented themselves have not had a voice in the debate
According to The Arizona Republic, some hospitals are reporting a decrease in the number of undocumented patients seeking care. There is no data on the percentage of undocumented immigrants in Arizona returning home to seek health care, but the lack of health insurance among members of this group may not be the only factor behind the trend. The current climate in the state, with a crackdown on undocumented workers, has caused many to leave, authorities report.
“We are definitely seeing a reduction in the number of undocumented immigrants seeking care at the hospital,” Sister Margaret McBride, a St. Joseph’s Hospital vice president, told the Republic.
For some public hospitals, the story is a little different.
The Maricopa Medical Center in Phoenix, which serves a majority of low-income residents, with many Latinos among them, has experienced an increase in oncology patients who are uninsured. Other hospitals are referring cancer patients to this institution once they’re stabilized, said Michael Murphy, a spokesperson for the Maricopa Integrated Health System.
Murphy said their hospital doesn’t ask about a patient’s immigration status.
The federal Emergency Medical Treatment and Active Labor Act requires hospitals in Arizona and across the country to provide emergency services to the uninsured regardless of their immigration status. But services don’t go beyond life-saving measures.
There is one exception. After the federal government decided in 2001 that kidney dialysis treatment wouldn’t be provided to undocumented patients, there was a lawsuit filed in Arizona arguing that this treatment should be considered an emergency lifesaving procedure. The lawsuit was settled in 2007, and now undocumented immigrants in Arizona may receive dialysis.
"Leaving is not really the problem, returning is,” said José Guadalupe Funes, a Mexican immigrant.
“This is a moral question: everybody, no matter where they come from, should have access to health care,” said Linda Herrera, organizer with the grassroots group Unidos in Arizona, which connects immigrants with legal and health resources. Herrera recalled the case of a Salvadoran woman who died two months ago returning across the desert after going to El Salvador for an operation. She left her four children in the U.S.
“There are lots of people who are sick but they’re not able to leave. The other way is for them to go to Mexico and return (across the border). Leaving is not really the problem, returning is,” said José Guadalupe Funes, a Mexican immigrant.
Listen to Funes (in Spanish):
[audio:http://feet2worlds.centernyc.org/JoseGuadalupeFunes.mp3]It is very sad that migrants with or without documents have to make health choices in which their lives are at risk because of a lack of health care, Herrera said. She was referring to the fact that migrants who are lawfully in the country are not covered by AHCCCS, the state’s insurance for people with low incomes. Permanent legal residents (green card holders) have to wait five years before they qualify for AHCCCS.
How little or how much care undocumented migrants should receive has sparked much debate in the State Legislature over the years — and even a referendum to try to limit access to health care by undocumented immigrants. In 2004, voters passed Proposition 200, aimed at limiting the public services that undocumented immigrants may receive. Its promoters argued that, by requiring the use of identification, it would help prevent fraud by people applying for state subsidized health insurance. The system already has safeguards in place that verifies a person’s eligibility based on immigration status.
“The abuse to the health care system can’t happen, because you don’t have insurance”, said Funes. “You go to the hospital and they take care of you, but they charge you too.”
According to the Pew Hispanic Center (click for report in pdf), about 7 million undocumented immigrants are uninsured.
“You have to have a right to care, just because you’re a human being,” said Jesus Aguilar Saenz, an undocumented worker. “I think it’s wrong for them to exclude us from health care reform.”
Listen to Saenz (in Spanish):
[audio:http://feet2worlds.centernyc.org/JesusAguilarSaenz.mp3]
Saenz said his family is afraid of seeking hospital services, because they fear they could be turned over to immigration authorities.
“On one occasion, my daughter fell and she was hurt. And the simple fact of taking her to the hospital starts the investigations on what happened. And you get scared because you don’t have documents,” he said.
Saenz added he doesn’t rule out returning to Mexico.
