OPINION | Treat Workers With Dignity; Expand Access to Insurance for Everyone in Washington

by Dr. Julian Perez

As a provider at Sea Mar, a safety net community health center, I see the reality of our health care system: When people don't have a way to pay for health care, they delay getting care until it's an emergency. To make matters worse, many lifesaving treatments, like organ transplants, are only available to patients with insurance.

Right now, there are 73,000 people in Washington who cannot get health insurance because of where they were born. We are a nation of immigrants that runs on immigrant labor. Immigrants build our houses, they grow our food, and many have lived in the U.S. for the majority of their lives. But when they fall ill, their immigrant status denies them the dignity of access to health insurance. This year, the Washington State Legislature can change this dire situation by expanding the criteria for insurance access.

Recently, I dealt with a tragic case that showed how the lack of access to insurance causes unneeded pain and suffering. One of my patients was diagnosed with an aggressive but treatable form of leukemia. She had lived and worked in the U.S. for 17 years and had three young children who were all U.S. citizens. Unfortunately, despite years of work in this country, my patient was undocumented and therefore ineligible for insurance at the time. Her oncology team was able to get her on medication to manage the disease, but full treatment required a bone marrow transplant — a service that hospitals will not provide to uninsured or undocumented individuals.

Unable to afford a bone marrow transplant, my patient developed an allergy to the class of medication that was keeping her alive, and she died. The experience of watching their mother pass away, effectively because her immigration status stood in the way of insurance and access to treatment, was traumatic for her family.

There is no nuance to this issue: We are sentencing our neighbors to death because they were born in a different country.

Most undocumented workers are stuck in a tragic catch-22. The U.S. desperately needs them to fill essential jobs in agriculture, construction, and elder care, but does not have a legal mechanism to give them permission to do the work they have been doing for years.

It's time we treat undocumented people as human beings. In my work with low-income patients, I've seen the pride people have when they can get insurance. Insurance means people can see a doctor regularly and not panic when they feel sick that they will lose their homes or families. Insurance gives people a sense of dignity and worth.

Insurance also saves our state from spending on unnecessary emergency care. Working in an orchard or in a meatpacking plant is physical labor that takes a toll on people's bodies. Insurance would allow people to have regular physicals, receive screenings for cancer, and detect kidney disease before surgery is required.

This year, the Washington State Legislature has the chance to fully fund a state-based coverage program for people who meet the income requirements for Medicaid but are ineligible due to their immigration status.

It's time our state acknowledges the reality of our workforce and expands access to insurance coverage to everyone in Washington.

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Julian Perez is a family physician at Sea Mar Community Health Centers.

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