Marin Sen. McGuire: Health clinics challenged by Trump immigrant policy
“The state of California is going to need to have a serious conversation about keeping community clinics across the state whole,” McGuire, D-Healdsburg, said after the Marin Community Clinic’s annual briefing for donors held at Embassy Suites Hotel in San Rafael. More than 100 people turned out for the breakfast meeting.
In September, the Trump administration announced a proposal to begin denying green cards to immigrants who use public benefits such as Medi-Cal; the Supplemental Nutrition Assistance Program, known as CalFresh in California and formerly referred to as food stamps; the Section 8 housing voucher program and the Medicare prescription drug program for older adults.
McGuire said this “public charge” proposal and the Trump administration’s general hostility toward immigrants has had a chilling effect, preventing many more immigrants than would actually be affected by the proposed changes from using public benefits.
“This is going to cost Marin Community Clinics’ bottom line about $1 million in the first year because patients are scared to come in and access quality health care,” McGuire said, “even though we believe the vast majority of patients will not be impacted by the public charge.”
Mitesh Popat, chief executive officer of Marin Community Clinics, said the clinics have actually seen nearly a $1 million drop in revenue already since Donald Trump was elected president and could lose a lot more due to the public charge proposal.
Popat said between December 2016 and now the Marin Community Clinics have suffered a 6 percent decrease in the number of patients who are insured under Medi-Cal and a nearly equal increase in uninsured patients, who pay on a sliding scale based on their resources.
“That’s pretty significant because we’re a nonprofit operating on a narrow margin anyway,” Popat said.
Dr. Matt Willis, Marin County public health officer, said, “It’s been a concern for us. We’ve done a lot of work trying to get people who are eligible for services enrolled in those services, especially women and children.”
“We made a lot of progress over the last two years and now we’re starting to see people dropping off because of the chilling effect,” Willis said. “There is a general distrust about what it might mean to have your name on one of these lists that the government has access to.”
There were 39,773 Marin residents receiving Medi-Cal coverage in December 2016; by July of this year that number had fallen to 38,803. During that same period, the number of monthly Medi-Cal applications submitted by Marin residents dropped from 751 per month to 377 per month.
In December 2016, 10,219 Marin residents were enrolled in Calfresh; by July of this year that number had declined to 9,788.
Meg Davidson, a policy and advocacy director with the San Francisco-Marin Food Bank, said, “We are definitely hearing from our partners on the ground that public charge is keeping people from accessing their public benefits. We are concerned about the impact on our participants because the immigrant families who qualify for Calfresh may choose to forgo it out of fear.”
Lucia Martel-Dow, director of immigration and social services at the Canal Alliance in San Rafael, said her organization, which provides free legal advice to immigrants, is counseling people not to panic.
“As of today, the law hasn’t changed,” Martel-Dow said. The review period extends until Dec. 10. Comments can be made at bit.ly/2C5AYdz.
Martel-Dow said it is also important for people to know that these proposed changes would only apply to people trying to enter the United States or get a green card.
People concerned about the cost of providing minimal public assistance to immigrants should know that according to the Immigration Policy Institute, 65 percent of non-citizens ages 16 to 64 who are receiving public benefits in the Bay Area are employed, Martel-Dow said. She said just over half of Marin’s families who are non-citizens rely on means-tested benefits.
During his presentation Wednesday, McGuire told the audience that immigrant workers make up 30 percent of the state’s workforce, and it is estimated that a tenth of that workforce is undocumented.
“Here in California diversity is who we are,” McGuire said. “Our diversity in this state has made California the fifth-largest economy in the world.”
