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Undocumented Farm Workers Are Hardest Hit When Health Care Safety Net Is Cut

By Esther Yu-Hsi Lee

"Undocumented Farm Workers Are Hardest Hit When Health Care Safety Net Is Cut"

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apples picked by immigrant hands

CREDIT: ThinkProgress/ Esther Y. Lee

In Fresno County, California, the most productive agricultural county in the nation, hundreds of undocumented workers suffer from pesticide poisoning every year. But they will no longer have access to the county’s health care program for chronic illnesses, a judge ruled last week. Fresno County Superior Judge Donald Black ruled that the county would no longer pay to provide treatment for undocumented workers with complicated medical illnesses.

According to the Fresno Bee, the judge’s ruling would defund the Medically Indigent Services Program (MISP), a crucial health safety net used to provide specialized care for impoverished individuals and undocumented immigrants who have chronic diseases like diabetes and asthma.

Fresno County’s attorney argued that the implementation of the Affordable Care Act (ACA) rendered the MISP unnecessary since indigent individuals could now access the Medicaid expansion and that the only uninsured people would remain undocumented immigrants, which the county is not obligated to serve under state law. The ruling could affect about 4,500 undocumented immigrants living in Fresno County who access the MISP, but county officials are adamant that caring for these people could cost the county $25 million at a time when the state is only giving them $18 million. For the past 30 years, Fresno County has been court-ordered to provide health care for low-income people who have no other source of health care, including undocumented immigrants. Undocumented immigrants are legally prohibited from enrolling in the federal Affordable Care Act. Judge Black stayed his decision for 60 days because he expected an appeal.

Fresno County’s undocumented workers help to run the economy, in large part by growing the county’s $5 billion a year agricultural industry. But because the county annually takes California’s top spot for using the most pesticides, farmers are left with chronic diseases that are leaving them ill or dead. According to a 2013 study, a huge body of evidence supports “the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson, Alzheimer, and amyotrophic lateral sclerosis (ALS), birth defects, and reproductive disorders.” Although these diseases are rarely reversible, specialty care, like the one provided by the MISP, could help to alleviate the pain.

The rate of pesticide exposure is likely to go up. The amount of pesticides used has grown from 29 million pounds in 2004 to 32 million pounds in 2006. Between 1991 and 1996, there were 515 reported cases of pesticide poisoning in Fresno County, with at least 85 percent of pesticide poisoning violations between 1996 and 1997 carrying no penalties. Fresno once again took the top spot for the greatest number of reported pesticide poisonings from 1997 to 2000.

A recent analysis also found that 16 neighborhoods in Fresno County ranked among the worst in pollution exposure, an environmental issue that could lead to higher premature deaths caused by cardiovascular (like strokes) and respiratory diseases (like asthma).

As it stands, only a small portion of California’s 2.5 million undocumented immigrant population can access California’s Medi-Cal health coverage. That group includes about 125,000 Deferred Action for Childhood Arrivals (DACA) recipients who were given temporary legal presence and work authorization. State Sen. Ricardo Lara (D-CA) introduced legislation in February to expand Medi-Cal to all low-income undocumented immigrants with a household annual income of $32,000.

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