By Jim Mangia, MPH, President & CEO, St. John’s Well Child and Family Centers
I’m a child of immigrants. My grandfather emigrated from the slums of Naples to escape Fascism. He gained his American citizenship by fighting in the first World War. He worked as a doorman, opening doors for the elite on the upper east side of Manhattan during the week and shined shoes on the weekends to support six children – two of whom died young in the dilapidated tenements of the lower east side. Despite the hardship, he was proud to be an American citizen and he was forever grateful for the opportunities this country afforded him and his family. He spoke little English and was proud of his heritage. Our house was always filled with strangers he had met, more down on their luck than he, who my family would feed and clothe – even though we barely had enough for us.
What he drilled into us every day was the importance of education. My generation was the first to attend college. My parents and grandparents did nothing but struggle to make sure we had the opportunities they never did.
Now, almost two generations later, I have the privilege of leading a large network of nonprofit health centers in downtown and South Los Angeles, which provide healthcare to more than 160,000 patient visits each year. My cousins are doctors, and lawyers and businessmen, with houses in the suburbs and children in the best universities of our country – all as a result of my immigrant grandparents’ backbreaking sacrifices. The patients who come through our health center doors get care regardless of their ability to pay or their health insurance status. So many of them are new immigrants, not yet citizens. Fathers from Jalisco, Mexico. Mothers and children from El Salvador. Young men from Guatemala. Like my grandfather before them, they’re in the United States working to make a better life for themselves and their families and fleeing repression. They are proud and hardworking and they sacrifice for their children to have the life they never could.
I know who America’s immigrants are. I sit with them in our health center lobbies every day. In our waiting rooms I talk to patients like Gustavo, who washes cars for 10 hours a day, on his feet in the baking Los Angeles sun, surrounded by toxic chemical fumes, getting by on barely $10 an hour (if he’s lucky enough to receive enough tips from the car owners). I see the children of these immigrants whose moldy, roach-infested apartments are making them sick, requiring constant breathing treatments for asthma, or watching our pediatricians pull cockroaches from their children’s infected ears. Like my grandfather before them, these more recent immigrants are building this country. They are proud of their heritage and they are grateful to America for the opportunities we provide. And I believe with every ounce of my being that these patients and indeed everyone in this country have a fundamental right to health. In fact, isn’t that the very least we can do in exchange for the hard work and dedication immigrants show and have always shown for the American dream?
We have an opportunity as a nation to address the health status and access to care which our immigrant populations are currently denied as politicians in Washington begin the debate over immigration reform including how long it should take for a “pathway for citizenship” for the nation’s 11 million undocumented residents.
My grandfather lived to be an old man because he had health benefits through the Veterans Administration. My grandmother, ravaged by diabetes, died when I was six. She didn’t have access to the same benefits, nor could they afford health insurance. And she died before President Lyndon Johnson began the war on poverty which provided funding to the community health center movement from which the health centers I lead grew.
America’s greatness was built by immigrants, whom we welcomed and rewarded with the honor of citizenship. Let’s give our immigrant populations the healthcare they deserve so they can fully participate in continuing to build this country – the tradition and promise that was and still is America. Let’s support them in living their dream. Without direct access to healthcare services, immigrants often put off accessing care, or they use expensive hospital emergency rooms when they get sick, rather than regularly accessing primary care services at private physician offices and community health centers because they lack health insurance. This is a huge cost to our society that could be eliminated if newly legalized residents could have access to Medicaid and be allowed to purchase insurance on the state insurance exchanges created by the Affordable Care Act. But ensuring access to healthcare is more than a cost issue – it is a moral issue.
Immigration reform must include a guarantee of the right to health to every immigrant residing in this country. Immigrants must be afforded the same right to healthcare that Obamacare provides to all American citizens. The rallying cry for this effort: “Obamacare for all.” Let’s make sure that our immigrant populations can be healthy and productive members of our society. Let’s make sure that on day one of the passage of immigration reform, America’s new legal residents will have healthcare access for them and their children. That’s an America my grandfather would be proud of.