First came the Mexican consular photo identification cards that closely resembled U.S. driver’s licenses and allowed immigrants, including those in the country illegally, to establish credit and apply for government services.
Then the Mexican government worked with the Treasury Department to make sure the U.S. banking system remained open to immigrants.
Now Mexican consulates in the U.S. are taking on an even more formidable challenge: the healthcare system.
A program called Ventanillas de Salud, or Health Windows, aims to provide Mexican immigrants with basic health information, cholesterol checks and other preventive tests. It also makes referrals to U.S. hospitals, health centers and government programs where patients can get care without fear of being turned over to immigration authorities.
“Being undocumented, we thought we didn’t have the right to certain things,” said Rosalba Hernandez, 26, who came to the U.S. two years ago and lives in Panorama City. “We were scared to ask for information.”
Hernandez, a housecleaner, and her boyfriend, a gardener, said they rarely go to the doctor because of treatment costs and fear of deportation. But after a visit to the Mexican Consulate last week to get her consular ID card, Hernandez now knows she can get affordable insurance and free access to some government health services.
Launched in 2003 in Los Angeles and San Diego, the Ventanillas program is currently operating in 11 cities, including Chicago and Houston, and the goal is to have a version in all 47 Mexican consulates around the country.
“Health-related issues are a very important absent piece of information,” said Ruben Beltran, Mexican consul general in Los Angeles. “We’re filling the blanks.... The consulate is the prime location to disseminate that information to the Mexican community.”
But critics say that illegal immigrants are already an unchecked drain on the public healthcare system and that such programs will only allow them to reap even more benefits.
“It facilitates people remaining in the country illegally,” said Ira Mehlman, spokesman of the Federation for American Immigration Reform. “Clearly it is a policy of the Mexican government ... to get all the institutions in the U.S. to provide services to their citizens who are living here illegally.”
Mehlman said Los Angeles County, especially, should not be partnering with the consulate to provide health services. “The county is broke, they are cutting back on services, they are closing emergency rooms, yet they are dreaming up new ways to provide benefits to illegal aliens,” he said. “It’s lunacy.”
Health services to illegal immigrants in Los Angeles County cost the Medi-Cal program nearly $440 million in 2005, according to the California Department of Health Services. Statewide, that number was more than $1.1 billion last year.
Nevertheless, some recent research indicates that many illegal immigrants don’t regularly use the public healthcare system. A Rand Corp. study published last year found that adult immigrants in general, and the undocumented in particular, consume fewer healthcare resources per person than the native-born. In part that’s because immigrants are younger and healthier, and because they are less likely to have health insurance, the study found.
Illegal immigrants are not eligible to enroll in major government health insurance programs such as Medicare, Medicaid (known in California as Medi-Cal) and the State Children’s Health Insurance Program. In recent years, eligibility rules have been tightened to exclude even some legal immigrants.
At the Mexican Consulate in Los Angeles last week, Graciela Cazeres, 41, said she wanted to get medical insurance but thought all companies required her to have a green card.
A nanny in Beverly Hills, Cazeres was in a car accident with her boss and injured her knee. If her employer had not paid for the operation, Cazeres said, she doesn’t know what she would have done.
Consul Beltran said the Ventanillas program saves the county money by encouraging immigrants to seek preventive care, rather than waiting until they need much more expensive emergency care. Since the inception of the program, Beltran said, more than 286,000 Mexicans in Los Angeles have received information and referrals and more than 12,000 have received services they learned about through Ventanillas.
On a recent day at the consulate, while immigrants waited to get their consular ID cards, they listened to a charla -- or chat -- in Spanish about clogged arteries, healthy diets, the causes of asthma and the dangers of buying Mexican prescription drugs under the table.
Socorro Alanis, a community worker from the Los Angeles County Department of Health Services, also explained that pregnant women and infants are entitled to immunization and nutritional benefits through the federal program Women, Infants and Children, regardless of their legal status.
“This program is free,” Alanis said to the group, holding up a flier about WIC. “Many people don’t use it, because they think that they aren’t permitted. It’s to have a healthy baby and a healthy woman.”
A few steps away, a representative from Health Net explained a low-cost insurance program for immigrants. And Clinica Medica General offered free blood pressure checks through a mini-mobile clinic.
Celsa Perez, 51, lifted her sleeve, held out her arm and took a deep breath as the band tightened. The results: 150 over 90.
“Your results came out a little high,” outreach worker Diana Gaytan said, referring Perez to a clinic near her Los Angeles apartment. “Are you taking medication?”
Perez told Gaytan she learned she had high blood pressure two years ago but hadn’t been back to the clinic since and wasn’t taking any medication. The mother of two earns about $1,200 a month working at a clothing factory and said her only insurance is emergency Medi-Cal.
Hundreds of community health clinics around the country provide basic doctors’ care and diagnostic tests regardless of a patient’s immigration status.
But clinics aren’t the only places where illegal immigrants can get healthcare. Hospitals are obligated to provide emergency services. Federal law requires state Medicaid programs to cover such services for illegal immigrants who would otherwise qualify for the program.
In addition, some illegal immigrants are covered by federal payments that compensate hospitals for inpatient care provided to the uninsured.
And some of the undocumented in California and several other states can receive limited services, such as prenatal care, nursing facility care and some breast and cervical cancer treatment, from publicly funded programs.
“The temptation is how to get more from the U.S. system,” said Steven A. Camarota, research director for the Center for Immigration Studies, which favors curbs on immigration. “Part of the goal seems for the Mexican government to be relevant in the lives of its citizens in the United States.”
Ventanillas began as an experimental collaboration between the Mexican government and the Health Initiative of the Americas, a University of California program. The first two Ventanillas were funded with a grant from the California Endowment.
“In the L.A. Consulate, we noticed there were 1,000 or 2,000 people visiting on a daily basis, waiting for their appointments,” said Xochitl Castaneda, director of the Health Initiative. “They were hanging around, eating junk food, watching TV. And we thought: This is an opportunity. We can provide them with information about health and with referrals.”
Maria Cortez, an undocumented housecleaner who lives in Santa Clarita, went to the consulate last week with her husband and daughter to get ID cards.
But when she saw the Ventanillas counter, she asked what else besides emergency Medi-Cal she could receive. The consular employee explained that her two daughters might be eligible for a public health program.
For three months last year, Cortez said, she knew something was wrong with her stomach but only sought treatment when the pain became unbearable. When she went to Olive View-UCLA Medical Center in Sylmar, she learned she had an ulcer. She received a bill for $1,200, which wasn’t covered by emergency Medi-Cal. When Cortez told the hospital she had no way to pay that amount, they reduced her portion to $80.
“We have the right to health services,” Cortez said. “We are not delinquents. We work.”
E. Richard Brown, director of the UCLA Center for Health Policy Research, said allowing such programs to be sponsored on U.S. soil by a foreign government sends a strong message.
“There’s nobody who says [immigrants] should be allowed to die in the streets,” he said. “That just isn’t acceptable in our society.”
Alonzo-Zaldivar reported from Washington and Gorman from Los Angeles.
Begin text of infobox
Immigrants are less likely to have health insurance than are natives, and the situation is worse for illegal immigrants and their children.
Percent of adults without health insurance
Born in U.S. - 14%
Legal immigrant - 25%
Illegal immigrant - 59%
Percent of children without health insurance
Parents born in U.S. - 9%
Parents legal immigrants, child born in U.S. - 13%
Parents legal immigrants, child born abroad - 25%
Parents illegal immigrants, child born in U.S. - 25%
Parents illegal immigrants, child born abroad - 53%
Note: Chart shows the proportion of adults and children in families without health insurance at any point in 2003.
Source: Pew Hispanic Center