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Uncertainty comes with ‘mixed status’

By Marianne LeVine

An estimated 9 million people live in mixed status families, with one or both parents of U.S.-born children being undocumented immigrants.

For many of them, the Affordable Care Act may turn out to be a double negative: The adults will not get insurance through the law’s expansion of Medicare due to their immigration status, yet they can face financial penalties if their children are not insured. And fear of having their status exposed will stop some from even trying.

The story of Suary, a married mother of three in San Mateo County, reflects this national reality.

She and her husband are undocumented immigrants. Their children, the oldest of whom is 5, were born in the United States and receive county-based health services. Eventually, though, the new law will compel the children to receive insurance through Medi-Cal or Covered California, the state’s exchange.

Suary described trying to get them covered in the past. “It’s been difficult because [health providers] asked me for identification, which I don’t have,” she said.

Suary agreed to be interviewed if her full name was not published. She detailed how she has relied on a community clinic for assistance. The clinic has given her children a temporary, three-month coverage plan, and she has begun meeting with a social worker.

She hopes the Affordable Care Act eventually will include undocumented immigrants. She continues to worry about health care, particularly for her husband who works for a company that cleans auto parts and is exposed to chemicals on a daily basis. Suary and her husband will continue to rely on affordable county-based programs such as ACE, a program available to low-income adults who do not qualify for Medi-Cal.

While the clinic mentioned that changes to the health care system were taking place, Suary admitted she knows little about the Affordable Care Act, outside of media sound bites.

“If what people [are] saying is true and our children will have greater access to medical coverage, then, yes, I think the ACA is helping [mixed status families],” she said.

Language barriers and limited education pose additional challenges for undocumented immigrants.

“The community knows very little about the law,” said Bettina Rodriguez Schlegel, an attorney for the Legal Aid Society of San Mateo County, who works with LIBRE (Linking Immigrants to Benefits, Resources and Education). “And the conceptions are oftentimes misconceptions.”

Schlegel said a common misconception among mixed status families is that the county will share their information with U.S. Immigration and Customs enforcement.

The Affordable Care Act’s impact on mixed status families will, in part, be determined by whether or not a family makes enough money to file taxes, according to Rachel Kelley, a fellow at the San Mateo County Health Coverage Unit.

Families not filing taxes will remain “off the radar,” Kelley said.