From Clinic To Courtroom, Fighting For Immigrant Health Care

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OAKLAND, Calif. — Jane Garcia began as an intern at La Clínica de La Raza within the late 1970s, attracted by its mission to offer well being care to all — particularly immigrants, no matter their authorized standing or capacity to pay.

Forty years later, Garcia, 66, is the chief government officer of the group, which now operates greater than 30 clinics in Alameda, Contra Costa and Solano counties and serves about 90,000 sufferers a 12 months. About 65% of its sufferers are Latino, a lot of whom are immigrants.

Garcia, who has Mexican roots, grew up within the border city of El Paso, Texas. Her household ceaselessly visited the Mexican metropolis of Juárez for groceries, fuel and haircuts, she recalled.

So advocating for immigrants got here naturally to her as an grownup, Garcia mentioned, however she hasn’t restricted her advocacy to the clinics.

In the 1990s, California skilled a paroxysm of anti-immigrant attitudes, comparable to people who have manifested elsewhere within the United States in the present day. Then-California Gov. Pete Wilson, a Republican, cracked down on unlawful immigration and championed Proposition 187, which denied unauthorized immigrants entry to public well being care and training. The measure, adopted by voters in 1994, by no means took impact as a result of it was ruled unconstitutional by a federal courtroom.

Garcia took Wilson’s administration to courtroom in 1997 over its makes an attempt to defund prenatal take care of unauthorized immigrant girls via Medi-Cal, the state’s model of the federal Medicaid program for low-income folks. She filed the lawsuit on behalf of undocumented immigrant girls — and gained.

“It was a very brave thing to do back then, to put her clinic in the middle of this fight and be the spokesperson in this lawsuit,” mentioned Carmela Castellano-Garcia, CEO of the California Primary Care Association, which represents well being clinics. “I just remember being so impressed by her boldness.”

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Today, La Clínica is the lead plaintiff in one among a number of lawsuits difficult the Trump administration’s try to broaden the “public charge” rule, which might enable federal immigration officers to extra simply deny everlasting residency standing to those that rely upon sure public advantages, equivalent to Medicaid.

Federal judges quickly blocked the rule from taking impact in mid-October, so Garcia’s lawsuit is on maintain.

La Clínica de La Raza, although, has an extended historical past. It was based in 1971 by college students on the University of California-Berkeley who had been conscientious objectors to the Vietnam War, Garcia mentioned. Instead of serving within the armed forces, they made a take care of the federal authorities to arrange a free clinic in Oakland’s Fruitvale neighborhood, the place residents had recognized well being care entry as a foremost concern.

Garcia spoke with California Healthline’s Ana B. Ibarra in her workplace throughout the road from the unique Fruitvale clinic. Garcia’s workplace is stuffed with crops, portraits of farmworker activist Cesar Chavez, pictures of Our Lady of Guadalupe and a framed “Health for All” poster.

The interview has been edited for size and readability.

Q: Expanding well being care entry to immigrants has been your mission since Day One. What drew you to this trigger?

I grew up in el barrio in El Paso, Texas. My household bought many companies from public well being departments or via faculties. Our pictures, for instance. So, I understood the significance of public well being applications.

At the very starting of my school profession I used to be pre-med, however determined that chemistry and bio weren’t for me. When I used to be at Yale as an undergrad, I labored at a neighborhood well being middle as a translator and labored with principally Puerto Rican households.

Then I bought to La Clínica and actually liked what they had been doing. I simply liked what the clinic motion was all about — social justice. And it actually referred to as to me.

Q: Why do you imagine it’s vital that everybody has entry to complete well being care, no matter immigration standing?

Only by offering companies to everyone can now we have a real impression on the supply system. When the flu season comes, it doesn’t ask your immigration standing.

It behooves us all to maintain all our communities wholesome and to offer entry on the most simple stage in order that we keep away from emergency room utilization.

My daughter is an ER nurse and he or she tells me, “Mom, you don’t know how many people come in there using the ER inappropriately.” And that’s as a result of they don’t have entry to the rest. That’s their major care.

Q: Beginning in 1986, low-income undocumented immigrant girls might get prenatal care via Medi-Cal, however you’ve spent a few years defending that protection, together with in courtroom. Why was this so contentious?

Our focus has all the time been households, so we actually centered on offering entry to fundamental major care, and prenatal care was a giant concern for our communities again then as a result of it was a political lightning rod — you had girls who had been undocumented in search of companies.

We needed to struggle to guarantee that the hospitals we went to to ship our infants would admit our sufferers. And that our sufferers felt snug being there. We helped our sufferers entry Medi-Cal or develop cost plans with the hospital. I keep in mind our physicians listening to feedback like, “You’re turning our hospital into a county facility.”

We filed a lawsuit on behalf of some undocumented girls in 1997. They had been the actual troopers on this. I used to be simply the interface.

Q: Now La Clínica is difficult the Trump administration’s try to broaden the general public cost rule. How is this example just like your struggle within the 1990s?

When this public cost concern got here up, it was reminiscent from these days and every thing about it jogged my memory about Prop. 187.

That was only one large interval in time that was all about being anti-immigrant. And we’re seeing the identical issues in the present day: dad and mom holding their youngsters at house and our variety of appointments taking place. This is spherical two of the identical scenario besides that I believe now we have been in a position to change the narrative considerably.

Particularly right here in California, we don’t see the phrase “illegal” as a lot, and we see fewer visualizations of individuals crossing the border like cucarachas [cockroaches]. The messages that we had been giving to sufferers at the moment weren’t very totally different from the messages that we’re giving to sufferers proper now. They are: Continue to get your companies right here, we’re a protected place, and we don’t share your info.

Q: Is this the place you thought the nation could be going into the 2020 election?

As a rustic, we’ve undoubtedly taken some steps backward, there’s no query about that, however we’re not ranging from level zero. As advocates, we’re manner higher armed with information and we are able to present you the way a lot taxes immigrant households pay, we are able to inform you how important they’re to the workforce.

I believe California, whether or not people prefer it or not, is a pacesetter. And with the state’s dedication to cowl everyone, we will reveal that, ultimately, that technique is the best way to go by way of having extra wholesome communities and a extra productive society.

Use Our Content This story will be republished at no cost (details).

This KHN story first revealed on California Healthline, a service of the California Health Care Foundation.

Ana B. Ibarra:”>, @ab_ibarra

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