Immigrants fear losing cancer treatments, essential surgeries if lawmakers revoke health care access

Micaela has spent three decades tirelessly cleaning houses, working as a clerk and now owns a shop in the Twin Cities that she tends to seven days a week, only closing Christmas and New Year’s Day.

But those efforts have left telltale signs on her body. She struggles to walk because of debilitating knee pain brought on by years of grueling cleaning work she performed when she first arrived from Mexico. Micaela’s daughter, Isis, helps her to and from the car, stocks the shelves and escorts her to the bathroom.

Micaela, who only gave her first name because she is undocumented, was hopeful she could finally get treatment when Minnesota opened its state health insurance for low-income residents to undocumented immigrants. She has an appointment scheduled for her knee next month.

Now, she’s not sure she’ll be able to get surgery as the state weighs revoking coverage for Micaela and thousands of fellow immigrants under a budget deal struck between lawmakers in St. Paul. She said she’s leaning on her faith for support.

“God knows what we can do at this point,” Micaela said via translator. “We just – we’re at his mercy.”

The Minnesota Democratic trifecta voted in 2023 to open MinnesotaCare to undocumented immigrants, but since the program began in January, enrollment has far exceeded expectations. The state had projected about 5,800 people to sign-up by the end of March, but more than 17,000 people entered the program. By the end of April, enrollments hit more than 20,000.

Only about 4,300 enrollees have had appointments for which the state has paid out, but Republicans warn the costs of the program may balloon as additional claims roll in.

Gov. Tim Walz and legislative leaders struck a budget agreement earlier this month that would remove undocumented adults from MinnesotaCare but allow children to remain on the program. Approximately one-quarter of enrollees are minors, according to the state.

The deal, which has not yet been approved by the Minnesota Legislature, has been met with backlash from progressive lawmakers and organizations that advocate for immigrants. In the two weeks since the deal was announced, protestors at the Capitol have shamed Walz and legislative leaders and accused them of abandoning immigrants.

Rep. Esther Agbaje, DFL-Minneapolis, criticized Republicans, who have made rolling back MinnesotaCare for undocumented immigrants a priority this legislative session.

“It is especially sad that they have injected into the conversation that some people must simply be left to die because their costs are too expensive,” Agbaje said at a news conference at the Capitol.

Sen. Jordan Rasmusson, R-Fergus Falls, said the costs to provide coverage are too great and Minnesota shouldn’t “incentivize illegal immigration” by providing benefits like MinnesotaCare. He said his constituents and neighbors are glad to see the Legislature “put Minnesotans first.”

He noted that Illinois and California are scaling back coverage or pausing enrollment in health plans for undocumented immigrants because of the costs.

“It’s actually quite unusual to have a broad-based, taxpayer-funded healthcare benefit for illegal immigrants,” Rasmusson said, “and in the states that have tried it, it hasn’t worked.”

When Micaela first came to the U.S, she was often required by employers to scrub floors on her hands and knees. After a while, the physical demands of the work took their toll on her joints.

“There’s not a single day or minute that she doesn’t pass with pain,” her daughter Isis said via a translator.

When Micaela’s not at work, she’s resting to prepare herself for another day.

Micaela said she tried to buy health insurance in the private market, but she couldn’t without a Social Security number. She inquired about paying out of pocket for surgery to help with her knee pain, but she can’t afford it.

Sitting behind the counter of her store, which sells probiotics and other items, Micaela said she doesn’t like to ask for handouts.

“It gives us shame to even think about being supported by government,” Micaela said, “but the thing is, I haven’t asked for anything at this point, and I pay for taxes when I run my business.”

“Everything I’ve done, I still can’t afford to even cover my surgeries,” she added.

Minneapolis City Council Member Jason Chavez’s father also faces the possibility of losing his access to health insurance as he undergoes treatment for cancer.

Chavez spoke about his father’s diagnosis in a news conference at the Capitol earlier this month. He had been keeping his father’s illness relatively private, he said in an interview, but decided to go public in the hope that “maybe…someone would think about not stripping healthcare away from our most vulnerable community members.”

“For my father,” Chavez said, “I had to.”

Chavez said his father did not want to be interviewed.

Chavez joined Agbaje and other lawmakers in the People of Color and Indigenous, or POCI, Caucus at the Capitol to urge their colleagues to protect MinnesotaCare.

He criticized Democratic legislative leaders for using health care “as a bargaining chip to balance a budget” and said Democrats’ top priority had been protecting health care access “for all Minnesotans.”

“I’m disappointed that that isn’t a priority anymore,” he said.

On social media, he said he was “extremely disappointed” that Senate Majority Leader Erin Murphy, DFL-St. Paul, signed off on the deal given Democrats control the Senate by a one-vote majority.

“We won’t forget that your re-election is next year,” he wrote.

POCI Caucus members pounded on the door of the governor’s reception room as Walz, Murphy and House leaders announced their proposed budget deal, accusing them of “killing our communities.”

Faith groups have held news conferences at the Capitol and read stories of immigrants like Micaela hoping to sway lawmakers. A factory worker in southern Minnesota lost a foot to diabetes she couldn’t consistently manage, said Melissa Gonzalez, a pastor at Tapestry Richfield. Now on MinnesotaCare, she has access to insulin and regular doctor’s appointments.

Murphy and House Democratic Leader Melissa Hortman, DFL-Brooklyn Park, have said the decision was a difficult one.

“I’m not at all surprised that this is the response,” Murphy said as DFL lawmakers and others pounded on the door two weeks ago.

“They are Minnesotans,” she said. “They work in our communities. They work with and alongside us. They go to church with us. They are our neighbors.”

With a tied House and a razor-thin Democratic majority in the Senate, legislative leaders are struggling to put together a budget. Lawmakers adjourned May 19 without a budget, and with each week that passes, Minnesota draws closer to a partial government shutdown.

Whether to end MinnesotaCare for people like Micaela has proven among the most contentious issues and could make it difficult for leaders to get DFL votes for a budget deal without health care for immigrants.

Rep. Jeff Backer, R-Browns Valley, who volunteers as an emergency medical technician, said he feels compassion for those who need access to health care, but lawmakers have to ensure the system is solvent to serve “law-abiding Minnesotans.”

Backer, co-chair of the House Health Finance and Policy Committee, said he has to “look at the whole ecosystem of our healthcare system.”

Micaela’s appointment for her knee is just around the corner, and as she awaits treatment, she’s heartbroken that MinnesotaCare might be revoked. To keep her spirits up, though it’s exhausting, she says she’ll keep coming to work.

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