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Uninsured Californians seeking post-wildfire federal aid will face Social Security questions

The undocumented are California's largest group without health insurance and mostly ineligible for a Social Security number.

OAK HILLS, CA - AUGUST 19: Miguel and Mabel Ramos, both 73-year-old, are traumatized by the devastation caused by Blue Cut Fire that swept through his residence, on 6500 block of Oak Hill Road, burning guest house to grond, burning two cars and killing about 135 animals Oak Hills. (Photo by Irfan Khan/Los Angeles Times via Getty Images)
OAK HILLS, CA - AUGUST 19: Miguel and Mabel Ramos, both 73-year-old, are traumatized by the devastation caused by Blue Cut Fire that swept through his residence, on 6500 block of Oak Hill Road, burning guest house to grond, burning two cars and killing about 135 animals Oak Hills. (Photo by Irfan Khan/Los Angeles Times via Getty Images)

The federal government launched a program for uninsured Californians who lost critical medication during the weeks of devastating wildfires. But to access no-cost replacements, residents will be asked to provide a Social Security number. While a SSN is not required, the question alone could dissuade California’s largest uninsured group from seeking care: the undocumented.

The Department of Health and Human Services (HHS) initiated the Emergency Prescription Assistance Program (EPAP) last week for uninsured Californians living in Butte, Los Angeles and Ventura counties whose medications or medical equipment, like canes or walkers, were lost or damaged during the wildfires. HHS activated extra aid after declaring a public health emergency in California. Citizensthe press release stresses, are encouraged to go to any pharmacy participating in the program before December 31 to access a 30-day supply; most prescription drugs should be covered at no cost to uninsured patients.

“EPAP provides vital assistance to people without insurance who rely upon certain prescription medicines and equipment to protect their health after disasters,” said HHS Assistant Secretary for Preparedness and Response Robert Kadlec, M.D. in the press release. “I encourage citizens in impacted areas of California who qualify for this assistance to take advantage of it.”

HHS Secretary Alex Azar encouraged people to call 855-793-7470 for more information, so this ThinkProgress reporter did. The operator said residents will need a Social Security number to access care.

An HHS official later clarified that the department is contracting with the pharmacy benefit management company, Express Scripts, to manage the program.

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“The procedure under that contract is to ask for a social security number, although a number is not required,” the HHS official told ThinkProgress over email.

“Callers who are not comfortable providing a social security number should state that they were informed a social security number is not required for program access and that they have proof of residence in the applicable zip code… These procedures were put in place under the contract to prevent fraud.”

The program doesn’t govern what pharmacies do.

Somewhere between 1.4 and 1.5 million undocumented residents lack health insurance and about half earn less than 138 percent of the federal poverty level, or $​27,821 for a family of three. Asking California’s uninsured population for a Social Security number presents a problem as only certain non-citizens who are authorized to work temporarily in the United States are eligible and the undocumented are not. 

Immigrant communities, documented and undocumented, are already forgoing government assistance because of xenophobic rhetoric. The fear of deportation or jeopardizing a pathway to citizenship has resulted in fewer families using food assistance, for example, 2018 data shows. Tethering citizenship to health care in any capacity further discourages immigrant families from seeking government help. This doesn’t just affect the undocumented, who make up nearly one in ten California workers, but citizens as well since many households are mixed status.

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Asking about SSN demonstrates a patter of intimidation from the Trump administration, a prominent California immigrant rights group told ThinkProgress.

“Clearly they have very little desire to help immigrant populations based on their rhetoric and their actions. I just think it reflects a misunderstanding as well of who needs help in the state of California and who really makes up the state of California,” said Gina Da Silva, Director of Government Affairs at the California Immigrant Policy Center (CIPC).

“We’ve heard stories anecdotally in Northern California, in Butte County, that they’re not seeing a lot of Latino families seek assistance even though they are a large part of the population. Then in Ventura, you are talking about a large Latino population but specifically an indigenous population… who are forced to work in the fields during very unsafe periods. And even under this type of effort, it is clearly not intended to support very important groups of communities in our state, which is mixed-status immigrant families.”

Immigrants will likely turn to emergency rooms for care or rely on aid from non-profits, she added.