Advocates fear GOP healthcare bill would limit services to immigrants

April 21--Lily, a 7-year-old Mexican national, couldn't get care in her country. Born with a tumor on her face, surgeons wouldn't operate because it wasn't cancerous, her mother, Katrina said through a translator.

She wouldn't provide her last name for fear of deportation.

When the family began struggling financially, they fled Mexico for California and the promise of affordable healthcare.

When they arrived, Katrina was able to sign Lily up for Medi-Cal through SB 75, a California law that guarantees children younger than 19 medical care regardless of immigration status. Roughly 5,200 people were signed up under the program in Kern County as of March 2017, according to the state Department of Health Care Services.

After Lily got Medi-Cal, she was able to get her operation, Katrina said through tears Friday at a forum in Bakersfield on the impacts repealing the Affordable Care Act could have on ethnic communities throughout the region.

Lily is just one of the thousands of immigrants throughout Kern County in fear of what options will be left for them if a Republican healthcare proposal that strips funding from Medi-Cal would pass. Legislation was introduced last month, but withdrawn at the last minute because of a lack of votes.

The matter has been top of mind this week as House Republicans have floated a new proposal with ideas drafted by Rep. Tom MacArthur, R-N.J. They've not scheduled a vote on or included the language in the Affordable Health Care Act, the Republican proposal to repeal and replace Obamacare.

A spokesman for House Majority Leader Kevin McCarthy would not comment on the record Friday when asked to respond to the fears of the immigrant community.

McCarthy has said in the past he remains dedicated to replacing the ACA, describing it as broken. Roughly 48 percent of those in Kern County rely on Medi-Cal, 11 percent of whom gained coverage under the ACA expansion.

"Our healthcare system is broken and will collapse if nothing is done. Premiums are rising, coverage options are disappearing, and Medicaid is on track to transform into a $1 trillion annual entitlement program we simply cannot afford," McCarthy said in a statement in February.

During Friday's forum, immigrant rights advocates spoke about the impact repealing the ACA would have, including on the limited benefits available to people in the United States illegally.

Clinica Sierra Vista, one of the state's largest healthcare providers for immigrants, would have to scale back its operations if legislators pass the American Health Care Act.

The clinic, a federally qualified health center, cares for 148,000 people annually, roughly 25 percent of whom are covered through the Affordable Care Act Medi-Cal expansion, which subsidizes costs for the poor through federal and state dollars. Those patients represent between $7 and $8 million in revenue for Clinica.

"You can't run a business without resources and so, if there's a cut in funding ... we will operate as much as we can financially afford, but with millions in cuts, we'd have to reduce services in some form," Bill Phelps, chief of program services for Clinica Sierra Vista, said.

Others told stories about how fear of deportation in the current political climate is impacting healthcare. Pregnant women in the country illegally aren't showing up for prenatal care, Rachel Vizcarra, a programs coordinator with the United Farm Workers Foundation, said.

"It takes a lot of time to establish trust in these outlying communities," Josth Stenner, an organizer with Faith in the Valley, said. "We don't want to lose the ground we've gained."

The forum might have raised more questions than answers.

"If we take a cut in the billions to Medi-Cal, how would we make up the difference? Do we cut services or cap enrollment? Who would be cut?" Edgar Aguilar, a program manager for Dignity Health's Community Health Initiative of Kern County, asked.

When healthcare cuts are made, historically, rural areas are the first to suffer, Phelps said, referencing Arvin, Lamont and other rural towns south of Bakersfield.

"They often carry the heaviest burden in environmental risks and also end up being the ones left behind and forgotten," Phelps said.

Harold Pierce covers education and health for The Californian. He can be reached at 661-395-7404. Follow him on Twitter @RoldyPierce

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