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Aging, undocumented and uninsured immigrants challenge cities and states

Teresa Wiltz, Stateline.org on

Published in Health & Fitness

In Los Angeles, Dr. Christina Hillson, a family practice doctor at the Eisner Health Clinic, said she's seeing a growing number of undocumented patients in their 60s to 80s, whom she's treated for everything from ovarian cancer to amputations resulting from untreated diabetes.

Her clinic is part of My Health LA, a Los Angeles county program that provides free primary care to low-income patients, including some undocumented patients if they qualify.

Patients who are critically ill are classified as emergencies and are able to get treated through the hospital system, she said. Sometimes, when patients aren't as sick, Hillson will still refer them to the ER, because it's the only way she can get their testing for a potentially deadly illness covered and get them connected to a specialist. She recently had to refer a 68-year-old undocumented patient with rapidly growing breast cancer to the ER, because that's the only way she would be treated.

Most undocumented immigrants came to this country as young people and tended to be healthier than native-born citizens, Wallace said. But as they age, they lose that advantage, he said. This may be due to a combination of factors, from poverty to tough working conditions to adapting to American-style bad habits such as increased consumption of junk food and decreased physical activity, he said.

Of the country's aging immigrants living here without documentation, women are more likely to have family in the U.S. who can help care for them as they age, said Randy Capps, a director of research at the Migration Policy Institute. But men, like Marcos, are more likely to be single and without a family support system. Because they often work as manual laborers, they're more likely to be disabled from on the job injuries, Capps said, a number that's likely to increase in the coming years.

"They're going to age faster and become disabled at higher rates," Capps said. "It's going to make for a much tougher old age." There's no one easy solution to helping older residents who live in the United States illegally, health and immigration experts say.

"The policy solution for illegals is to enforce the law and encourage them to return home, thereby avoiding the problem," said Steven Camarota, director of research for the Center for Immigration Studies, a conservative think tank that favors limiting immigration. "If someone wants to sponsor an elderly parent, making sure the sponsor has insurance for them before they come would solve much of the problem."

Joe Caldwell, director of long-term services and supports policy at the National Council on Aging, an advocacy group, said community health centers could possibly provide acute care to undocumented seniors. And federal immigration legislation that provides a pathway to citizenship would put seniors in line to receive Medicare and Medicaid, he said.

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Such legislation is unlikely any time soon.

Outside the Home Depot, Marcos and his friends gather in the cold sunshine, talking animatedly. He's been paying taxes for years, Marcos said, and he's got pages of documents to prove it. He'd love to become documented, "but that's practically impossible," he said.

A year ago, Marcos said, he had tightness in his chest. Could've been a pulled muscle, could've been a heart attack. He's vague about the details. Without health insurance, he said, he had no choice but to go to the ER, but he hasn't followed up since then. He'd rather stalk the parking lot here, looking for work.

"No work," Marcos said, "no money."

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