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No Help for The Help

Posted: Feb 29, 2012

Reyna cries after telling of how she fled her native Honduras. She doesn’t have health insurance and pays cash for chemotherapy to treat her leukemia. (Photo by Mike Kane for Equal Voice News)

Reyna works nine, 11, sometimes 14 hours a day taking care of another family’s children for $400 a week. She hasn’t seen her own daughter in seven years, not since she fled political persecution in Honduras, ultimately making her way to Miami.

The money Reyna used to send home to help her daughter now goes to Reyna’s medical expenses as she fights a rare form of leukemia. She has no health insurance and can’t afford the transplant that could cure her condition.

Sitting on the bed in the tiny room she rents, Reyna, 46, fights back tears as she describes her daily struggle. She is often in pain, has had several strokes and must use a special machine that keeps her breathing while she sleeps.

“I live scared. This is my life. I can’t leave. I don’t know what to do. If I return, they kill me. If I stay, I die a little bit each day,” she said. “My oncologist says his other patients don’t work with this condition, but if I don’t work, I can’t go to him and I’ll die.”

Two years ago, Reyna’s application for asylum was denied and her permanent resident card revoked, leaving her among the estimated 11 million undocumented immigrants in the United States. She worries every day that her employer will learn that she is undocumented and fire her.

Reyna’s last name is not being used to protect her identity and allow her to share her story, a story of what happens when the immigration and health care debates converge. Her experience shows how off the mark stereotypes about undocumented immigrants and health care are.

Reyna, for example, pays for her chemotherapy treatments – in cash. In fact, an analysis by the Pew Hispanic Center found that 17 percent of undocumented Latino immigrants use clinics and doctors that require cash payment from uninsured patients.

Forty-one percent of undocumented Latino immigrants have health insurance according to the Pew analysis; many are covered by their employers’ health plans.

The Pew analysis also revealed that only 34 percent of undocumented Latinos missed a day of work because of illness in the previous year, compared with 52 percent of the general population.

Measures in place to make sure undocumented immigrants don’t receive federal health care benefits have been costly, with little return: According to the Government Accounting Office, for every $100 spent on verification procedures, Medicaid saved 14 cents.

In Reyna’s case, her doctors have requested she be given a humanitarian visa to remain in the U.S. because the chemotherapy necessary to keep her alive is more complicated than any she would be able to find in Honduras. But, even if she were granted the visa, by law, Reyna wouldn’t be eligible for Medicaid benefits for five years.

“There’s a real need for some kind of health care safety net,” said Tanya Broder, senior staff attorney at the National Immigration Law Center (NILC). “A leukemia patient is an example of somebody whose life, without the right kind of treatment, could be in danger.”

Broder said some states may allow undocumented immigrants to qualify for Medicaid for treatments like chemotherapy under a provision that provides emergency services. Florida isn’t one of those states, however. NILC pushed to include provisions for undocumented immigrants in the Affordable Care Act that was passed in 2009. Instead, the act made it illegal for undocumented workers to participate in the new health care insurance exchanges, even if they cover the full cost.

As in most states, private employers in Florida are not required to cover health insurance for their domestic workers – documented or not.

Nationally, there are an estimated 2.5 million domestic workers. According to a December 2010 report issued by the Excluded Workers Congress, just 13 percent of domestic workers employed at least half-time, year-round, have health insurance provided by their employers.

The vast majority of domestic workers are female, foreign born, or people of color. In Miami, 91 percent of the domestic workers were born in South America, Central America, or the Caribbean.

Everything about her immigration situation and her health care scares and frustrates Reyna. She wipes away tears as she leafs through a folder of letters that friends, her lawyer and her doctors have written on her behalf, begging immigration authorities to grant her legal residency.

She feels so alone and wishes she could go home, at least to visit. She talks to her daughter on the telephone on weekends, when international rates are lower.

“I only told her I’m a little sick,” she said. “I don’t want her to suffer, worrying about me. There’s nothing she can do.”

She says she apologizes to her daughter often for leaving her when she fled Honduras. The child was 14 at the time. Two years earlier, Reyna’s older son was kidnapped and killed after she says she worked on a study that found drug dealers were adopting orphans to use in their criminal operations.

“We were living as prisoners in our country because of the gangs and the drug traffickers,” she said.

Even after her son was killed, she continued working with a nongovernmental organization to try to reform the country’s safety net for orphans.

“I didn’t want my son to die in vain,” she said. But after her family was threatened again and one of her coworkers was killed, she fled, leaving behind a professional career in psychology along with her family.

Reyna keeps pictures of her daughter and one of her son by her bed.

“The people here are good,” she said. “It’s the policies that are bad. The policies are inhumane.”

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