LOS ANGELES 鈥� For 26-year-old Paulina Ruiz, having legal immigration status is about more than going to school or holding a job. It鈥檚 about staying healthy.
The聽University of聽California-Los聽Angeles聽graduate,聽whose parents brought her聽from Mexico聽to the U.S.聽illegally聽two decades ago, has cerebral palsy, a neurological condition聽diagnosed shortly after birth.
In the past, Ruiz said,聽she relied on emergency rooms for聽her health care聽and聽rarely could see聽specialists.聽She聽developed聽kidney and back problems聽after聽years of inconsistent medical care and聽using an聽inappropriate wheelchair.
Paulina Ruiz, who has cerebral palsy, said losing her legal immigration status could mean losing her health coverage and access to doctors. Ruiz is on Medi-Cal, which helps cover some of the costs of her medical care. (Courtesy of Paulina Ruiz)
But in 2012, she qualified for the聽federal Deferred Action for Childhood Arrivals聽(DACA)聽program, which temporarily protected her from deportation. In California, that meant she could get Medi-Cal, California鈥檚 version of聽the聽Medicaid聽insurance program for low-income Americans, and regularly see a doctor.
罢丑别听罢谤耻尘辫听补诲尘颈苍颈蝉迟谤补迟颈辞苍鈥檚听肠辞苍迟谤辞惫别谤蝉颈补濒听聽the DACA program聽does more than put聽nearly 800,000 鈥淒reamers鈥� in fear of deportation and losing their jobs.聽It聽threatens the health care of聽thousands of聽young adults like Ruiz, who either have job-based insurance or whose incomes qualify them for Medicaid in California and several other states.
鈥淚 am very upset,鈥� said Ruiz, who organizes for the Coalition for Humane Immigrant Rights of Los Angeles聽and lives near the city.聽鈥淚 don鈥檛 know what鈥檚 going to happen to my health.鈥�
The decision is set to take effect in six months, unless Congress comes up with an alternative plan.聽Trump has said the program, started under President Obama in 2012,聽rewards聽聽by taking their jobs and聽depressing聽wages,聽a claim聽dispute.聽Attorney General Jeff Sessions聽said聽Tuesday that the program was聽聽because聽it was a unilateral executive action on a proposal that had been repeatedly rejected by Congress.
Trump, who has聽suggested聽he has聽conflicting聽sentiments聽about the program,聽left open the door for Congress to change聽it.聽鈥淚 have a love for these people, and hopefully now Congress will be able to help them and do it properly,鈥� he said, according to聽聽But the newspaper noted that he did not call for bipartisan legislation to restore聽its protections.
The program聽allows聽immigrants聽between the ages of 16 and 31聽who were聽brought to the United States聽illegally聽as children to receive work permits and聽temporary聽protection from deportation. Those who qualified were聽explicitly聽barred from receiving federal health聽benefits through Medicaid, Obamacare exchanges or other聽programs.
Many聽DACA recipients now have聽jobs with health insurance.聽In聽addition,聽California,聽New York,聽Massachusetts, Minnesota and the District of Columbia have聽used their own money to cover low-income聽Dreamers聽through Medicaid, according to聽Tanya聽Broder, a Berkeley, Calif.-based senior staff attorney for the National Immigration Law Center.
Maria Garcia, 22, said she was able to get a job as a receptionist at a Los Angeles hotel because of the DACA program. The job also came with health insurance, which helped cover physical therapy from a knee injury. She fears getting fired and being unable to pay for her own health insurance and medical care. (Anna Gorman/KHN)
础苍听聽people qualify for聽DACA in California. There are an estimated 220,000 DACA recipients in California, the largest number in the country. Those聽who聽meet聽聽鈥斅�138 percent of the federal poverty level or $33,534 for a family of four 鈥斅燾an聽qualify聽for coverage under the state鈥檚 鈥淧ermanently Residing in the United States聽under聽Color of Law鈥澛�.
That聽coverage聽is now in question.聽In California, those at risk聽of losing Medicaid聽are 19 and聽older, because the state under a separate law decided to cover all聽low-income聽children, regardless of immigration status, through age 18.聽That decision was not connected to the DACA program.
With the federal government鈥檚 action,聽鈥渘obody will lose coverage in the Medi-Cal program immediately,鈥� said Ronald Coleman, director of government affairs for the聽California Immigrant Policy Center, an immigrant advocacy group. But Coleman worries about what happens聽after March 5, when DACA鈥檚聽protections will end聽鈥� unless Congress takes action to protect the program.
The Department of Health Care Services, which oversees Medi-Cal,聽could not provide a comment on Tuesday, a spokeswoman said.
Marielena Hincapi茅, executive director of the National Immigration Law Center, told reporters聽in a conference call聽on聽Tuesday聽that she expects DACA recipients to start losing their聽job-based聽health insurance. Hincapi茅 said she聽is聽particularly聽concerned about the聽effect of聽the president鈥檚 decision on the mental health of DACA recipients.
鈥淭he need for mental health services will only be greater,鈥� she said.
Jocelin Reyes, 19, said having protection from deportation relieved her fears and anxieties. But now, the University of California-Santa Barbara student said, 鈥渢he fear has tripled.鈥� (Anna Gorman/KHN)
At聽a protest聽in downtown Los Angeles Tuesday against the Trump administration鈥檚 decision, Jocelin Reyes made a similar point. She said聽DACA鈥檚 protections had helped聽put聽some young immigrants鈥櫬爁ears to rest, as聽they聽were able to get jobs, attend college or graduate school and come out of hiding.
鈥淎 lot of people don鈥檛 understand how much fear we had鈥� about being deported,聽said聽Reyes, 19, who is about to start school at the University of California-Santa聽Barbara.聽鈥淣ow that fear has tripled.鈥�
Another demonstrator, DACA recipient聽Maria Garcia, 22, said that聽losing her聽job as a hotel receptionist聽would mean the end of聽her job-based health insurance 鈥� coverage she聽relies on for physical therapy for a knee injury and any time she gets sick.
鈥淚f they take away my DACA, I鈥檒l get fired,鈥� she said. 鈥淎nd then what will I do for health insurance?鈥�
State Sen. Ricardo Lara (D-Bell Gardens) said ending DACA would only hurt 鈥渢he well-being of these American children who have played by the rules.鈥� And聽they could end up having to go to聽costly聽emergency rooms for medical care.
Lara, who led the charge to get聽, said one possible solution in California would be to increase the age limit for Medi-Cal coverage for kids from 18 to 26.
鈥淲e have to answer this call to ensure that our DACA students and workers are not pushed aside,鈥� he said.
The California Medical Association said that terminating DACA could indeed hurt the health care workforce.
鈥淥ur nation鈥檚 health care system has the largest percentage of foreign-born and foreign-trained workers of any industry in the country. Already facing a national shortage of physicians and other health care professionals, revoking DACA could also undermine patient care and disrupt medical schools and hospitals for decades to come,鈥� said California Medical Association President Ruth E. Haskins in a statement.
Ana B. Ibarra contributed to this report.
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