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How Los Angeles is testing ways to keep undocumented immigrants healthy

When Martin Machain arrived to Los Angeles from Mexico years ago, he didn’t know where to turn for health care. Machain migrated to the US to escape poverty and change his life. But without insurance, it hasn’t been easy.

He’s one of an estimated 400,000 immigrants living in Los Angeles County without legal status and uninsured.

These days, Machain works seven hours a night as a janitor, cleaning industrial kitchens. It’s a tough job, but pays the rent. He worries, though, that his work may affect his health. “I think the liquids I handle at work may affect me because I use many chemicals,” he says. “It's dangerous, especially for someone like me who has asthma. I have to be very careful.”

At a previous job in a recycling plant, he fell down hard while working on a conveyer belt. It left him with a lifelong back injury. Now, he’s 51 and has to deal with even more ailments, including diabetes, cholesterol, asthma and kidney problems.

But in Los Angeles, there’s a new program that provides free, ongoing health care to undocumented immigrants. Under the county’s $61 million dollar program, My Health LA, Machain now gets free primary health care at a local clinic.

There are 135,000 people enrolled in the program. But that’s still less than half of L.A,’s undocumented, uninsured population. Part of the problem: getting the word out to people who qualify. Also, the funding falls far short of including everyone who is eligible.

Martin Machain, who has diabetes, makes lunch in his kitchen. He is undocumented and works nights as a janitor, cleaning industrial kitchens, but he isn’t eligible for health insurance under the Affordable Care Act. A new health program in LA is helping fill the gap for his primary health care needs.

Credit:

Sonia Narang

Machain’s clinic is only a five-minute walk from his home. He says the care he gets through the program is better than at the county hospital. That’s the only other place he can get no-cost treatment, but it’s not meant for regular health check-ups.

“At the general hospital, the waiting room is packed with people, nothing like here at the clinic,” he says. “One time, when I was bleeding from my kidneys, they didn’t take care of me for three days, because there were people that were doing worse than me.”

Martin Machain walks down the street to a health clinic that serves undocumented and uninsured residents in LA. It’s a five-minute walk from his home. 

Credit:

Sonia Narang

My Health LA isn’t insurance, though. Rather, the program pays clinics a monthly fee to provide patients like Machain free primary care, prescription medicine, labs and tests.

But, not everyone agrees taxpayer money should fund programs like this. A recent University of Southern California/LA Times poll found that nearly half of the state’s voters are against subsidizing health care for undocumented immigrants.

“Well, what makes you think you’re not paying for it already?” asks Mario Chavez, director of government affairs for St. John’s clinic in L.A.

That’s because taxpayers are still responsible for covering county hospital emergency room costs.

Health experts say programs that fund preventative health care are more cost-effective than treating people in the ER. “We could save more by giving people services up front, rather than waiting for conditions to appear and then dealing with it after the fact,” says Michael Rodriguez, a professor at the School of Medicine at the University of California, Los Angeles. 

My Health LA has become a model for other US cities and counties. But public health experts say that programs like this need to go beyond just basic care and include in-house specialists and mental health services.

Back at the clinic, a group of middle-aged and elderly diabetic patients dance to catchy Zumba music in a group exercise class. Machain and the others also get nutrition advice about what foods to eat. “I feel like I'm around family when I go to the clinic,” he says. “Maybe it's because I'm alone here, because I have no family here. So, I feel like the clinic is my home.”

This story was supported by KCRW's Independent Producer Project.


From PRI's The World ©2015 Public Radio International

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