For the undocumented aging, medical care is challenging

By JOSHUA BENDER
Capital News Service
LANSING — Luis Valencia said he came to Detroit from Mexico 10 years ago with his mother and brothers to escape drug dealers.
He had drawn the ire of a drug cartel because of his reporting on their activities, said Valencia, a journalist.
Today, his mother has severe diabetes and may soon require expensive dialysis, he said. But that’s not an option because of his family’s undocumented status. Doctors have advised him to return his mother to Mexico to receive treatment they can better afford, he said.
He would not be safe in Mexico, he said through Adonis Flores, an immigrant rights organizer for Michigan United, a Detroit-based advocacy group who interpreted for him. A few months ago one of his cousins was killed in Zamora, a city in Mexico.
Aging is hard enough on a person’s health.

Doing so without legal citizenship is even more challenging, say advocates of undocumented immigrants in Michigan.
Older undocumented immigrants are unable to apply for government-based retirement or health care benefits such as Medicaid, Medicare or social security, said Ruby Robinson, supervising attorney at the Michigan Immigrant Rights Center, an advocacy group with offices in Ann Arbor and Kalamazoo.
Undocumented migrants are eligible for Medicaid benefits in the event of a life-threatening emergency, he said. However this does not cover follow-up treatment related to the emergency.
As the population ages, it’s difficult to get a handle on the scope of the problem, experts say.
Collecting exact statistics on undocumented migrants is difficult, said Martha Gonzalez Cortes, communications director for the Department of Civil Rights. “There isn’t a lot of data available because of the large number of people who live off the grid.”
Roughly 1 in 5 undocumented Michigan immigrants is 45 years old or older, according to estimates by the Center for Migration Studies, a New York-based think tank that studies international migration. The number of those older than 65 went from none in 2010 to 931 in 2014.
Robinson said that undocumented migrants can purchase private health insurance but the lack of a social security number or, in many cases, a substantial credit history makes doing so difficult.
Roughly half of Michigan’s undocumented immigrants are without  health insurance coverage, according to the center.
“This issue will only grow in scope as this population further ages,” Robinson said.
One of the consequences of living outside the government’s gaze is that while many undocumented migrants pay into retirement benefits through wage tax deductions for upwards of 20 years, undocumented people cannot collect social security or Medicare benefits, Gonzalez Cortes said.
Just over a quarter of Michigan’s undocumented population has lived in the U.S. for 10-14 years, while just over a tenth has been in the state for more than 20 years, almost double the estimate from 2010, according to the Center for Migration Studies.
Valencia’s mother’s mounting medical expenses are covered by his brother’s wages and an occasional check from an uncle in California, he said. Valencia’s family has no medical insurance or valuable assets they can sell i to purchase insurance. His mother is a patient at Community Health and Social Services Center, in Detroit, a nonprofit primary care health center that focuses on underserved populations.
“We feel rejected by the health system for not having insurance or assets but we also feel optimistic,” he said. “We are grateful for the help we get. Doctors tells us what food our mother should eat and how to best take care of her.”
Michigan Primary Care Association health centers serve low-income patients throughout the state, regardless of documentation status, said the association’s CEO, Kim Sibilsky. Patients without insurance pay according to their financial ability.
Seven association clinics serve large migrant populations, Sibilsky said. The clinics try to offer multilingual services as best they can.
However for patients like Valencia’s mother, the centers are less equipped.
“More long-term care services are not within our scope,” Sibilsky said. “Our health centers have been able to frequently negotiate relationships with local specialty care providers but those are more goodwill-based.”
The bulk of the funding for association clinics is provided by grants from the state government, she said.