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The Central Valley News Collaborative includes The Fresno Bee, Vida en el Valle, Valley Public Radio and Radio Bilingüe. The project was announced in late 2020 and began its work in 2021 with the Collaborative's reporters shining a light on how the Central Valley’s communities of color have been disproportionately impacted, physically and financially, by COVID-19. The Collaborative is now exploring how the drought and climate change could reshape the valley, and the lives of the people who work in the agriculture industry. The Collaborative is supported by the Central Valley Community Foundation, with technology and training support by Microsoft Corp.

Gavin Newsom proposes expanding Medi-Cal to all Californians. Here’s how the benefits would help one Fresno County couple

Medi-Cal
Nadia Lopez
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Maria Guadalupe Toledo Mejia and her husband Sergio Tulio Arevalo Solis sit in their kitchen in Riverdale, an unincorporated community in Fresno County. Arevalo Solis recently underwent open heart surgery.

Maria Guadalupe Toledo Mejia is rounding a ball of masa in her hands. She’s making baleadas for her husband, Sergio Tulio Arevalo Solis, in their apartment in Riverdale, an unincorporated community of nearly 4,000 people in Fresno County. They moved there in 2019 with their three kids, daughter-in-law and two grandchildren after escaping violence in their home country, Honduras. When they arrived, Sergio says he and his wife began working in the fields.

“Primarily picking grapes,” he says in Spanish, “but also wherever they’d send us, wherever there’s work.”

But in the last three weeks, Lupita and Sergio have been forced to stop working. In late December, 42-year-old Sergio says he was having trouble breathing so he drove himself to the nearest hospital. He’s undocumented and uninsured but he was able to get Medi-Cal in this emergency situation.

The doctors admitted him right away, quickly connecting him to oxygen. After a series of tests, Sergio says his doctor told him he had to have open heart surgery as soon as possible. But Sergio hesitated. He didn’t have the money to pay for the surgery.

“I told the doctor if my emergency Medi-Cal didn’t cover the surgery, then discharge me and send me home,” he says. “I’d rather die in my house.”

Gavin Newsom proposes expanding Medi-Cal to all undocumented Californians

Assemblymember Joaquin Arambula, who represents south and west Fresno County, says Sergio’s experience is a prime example of why the state needs to expand Medi-Cal to all Californians, regardless of immigration status. Before becoming an Assembly member, Arambula was an emergency room doctor in Sanger.

“Many people in our immigrant communities are fearful of seeking out health care if they do not have coverage,” he says.

He says this has always been the case for undocumented residents, but the pandemic highlighted the underlying inequities within the state’s healthcare system.

“It's the absolutely appropriate response for us as a state to take after seeing those disparities,” Arambula says.“ For us to turn around and invest in those very vulnerable communities to ensure that they have access to health care.”

The Migrant Policy Institute estimates there are 77,000 undocumented people living in Fresno County. Nearly half of them work in agriculture, which had the second highest increase in deaths of an industry during the first 10 months of the pandemic, according to an analysis by UC Merced Community and Labor Center.

Last week Governor Gavin Newsom, proposed expanding Medi-Cal to all low-income, undocumented Californians. The state Legislative Analyst’s Office estimates there are nearly 700,000 Califorians who would gain access to Medi-Cal, if it were expanded to all qualified adults regardless of immigration status.

The campaign to expand Medi-Cal to all low-income undocumented residents started nearly a decade ago. The state first expanded Medi-Cal to undocumented kids ages 19 and under in 2016. Undocumented people ages 26 and under got access to the benefits in 2020. And this year, undocumented people ages 50 and older will be able to apply.

But as of now, undocumented people between the ages of 27 and 49 still can’t get Medi-Cal, so the governor’s proposal is the last step toward expanding the health insurance to all Californians.

“I think Californians have all come full circle and embraced this idea that our neighbors and our friends and everybody that's contributing to the social fabric to the economy of our state, deserves to be taken care of,” says Sarah Dar, Director of Health & Public Benefits Policy at the California Immigrant Policy Center.

Dr. Efrain Talamantes, chief operating officer at AltaMed Health Services, the nation’s largest community health center, agrees. He says the undocumented and uninsured face the biggest financial burden in getting medical assistance.

“If [they] don’t have coverage, who is going to cover the behavioral therapy, the physical therapy, the nutritional therapy, the countless amount of therapies, so that we don't just save someone's life, but that we preserve them, so that they don't fall back into the same situation?,” he says.

The California Republican Party disapproved of Newsom’s overall budget proposal describing it as “woefully short on solutions that will fix the problems that are plaguing California.”

The state legislature can still revise the budget, but must approve it by June 15. Newsom will have until June 30 to approve it.

Fresno County couple anxiously await medical bills

Back in Riverdale, Lupita washes her hands before cleaning the wound on Sergio’s chest. He ended up getting the heart surgery at a clinic. But Lupita says they still don’t know if the procedure was covered by his emergency Medi-Cal.

“We’re lost,” she says. “We don’t know if or when we will receive a bill for the follow-up appointments.”

And Lupita says it’s all made more difficult by the fact that the medical staff didn’t speak or understand Spanish. “My husband had to download a translating app on his phone so we could communicate with staff,” she says.

Sergio says if the Medi-Cal expansion is approved, it could be life-changing for many.

“It would be excellent,” he says. “Even if it doesn’t directly benefit me, it will help a lot of people in my similar situation.”

In the meantime, Lupita says she’ll only take off two weeks to care for her husband. He’ll be in recovery for five months, she says, so she needs to get back to work in the fields to support their family of eight. They’re anxiously awaiting the medical bills.

This story is part of the Central Valley News Collaborative, which is supported by the Central Valley Community Foundation with technology and training support by Microsoft Corp.

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