Marco Loera Alvarez’s father, Daniel, started losing weight at an alarming rate after his family immigrated to Minnesota in 2004 from Guadalajara, Mexico.
Daniel Loera, 60, also became irritable and often experienced a sudden loss of energy.
He was later diagnosed with diabetes and hyperthyroidism, and put on prescription medication to control the illnesses. But Loera has struggled to regularly access the treatments he needs to live because he’s undocumented and doesn’t have health insurance. He expects to largely rely on the emergency room if anything goes drastically wrong with his health, but would face either high costs or denial of care in that situation.
The Rochester family hopes Minnesota lawmakers can help end the uncertainty they’ve been living with every day for almost 20 years by passing a final version of the MinnesotaCare Immigrant Inclusion Act, which would allow low-income undocumented Minnesotans to sign up for state health insurance.
“If you want healthy kids, give them healthy parents,” said Marco Loera Alvarez. “Parents are the ones suffering. They’re the ones with chronic illnesses, who are elder, and they need that care.”
Marco Loera Alvarez, 28, is a pharmacy technician and recipient of deferred action for childhood arrivals (DACA), which protects children who were brought to the United States as undocumented immigrants from deportation. Now, he’s advocating for the bill that would grant his parents, who are both undocumented, and tens of thousands of Minnesotans like them the ability to access MinnesotaCare.
The Minnesota House and Senate passed their versions of the bill, but must now reconcile the differences between them in conference committee before lawmakers can vote on a final bill and send it to Governor Tim Walz’s desk to be signed into law.
If a final bill is approved before the legislative session ends on May 22, the changes are expected to be implemented by 2026. The MinnesotaCare program currently requires recipients to be U.S. citizens or lawful residents.
The Senate’s bill would expand access to undocumented children under 19, whereas the House version would grant access to all low-income undocumented people and their families. Both bills were included in the health and human services omnibus bill, a package of bills funding programs in that department.
Unidos MN, a local advocacy group for Latinos in Minnesota, is pushing for the bill to include all income-eligible undocumented people regardless of age.
“We cannot separate the inseparable,” said Sara Lopez, Unidos MN’s policy director. “The impact is way bigger when you can have not only children, but their caretakers access healthcare. When a child gets sick, the parents almost always end up catching what the kid gets.”
Senator Liz Boldon, DFL-Rochester, sits on the bill’s conference committee and supports the initiative.
“Expanding access to MinnesotaCare for undocumented immigrants would have a transformative impact on thousands of lives,” Boldon said in a written statement. “I continue to strongly support this proposal and its inclusion in the Health and Human Services Conference Committee Report.
Washington, D.C., California, Illinois, Maine, New York, Oregon, Rhode Island, Vermont, and Washington offer state health insurance to undocumented children and pregnant individuals, according to the Kaiser Family Foundation. Massachusetts and Connecticut recently expanded their coverage to children without immigration status, too.
Washington, D.C. recently expanded its healthcare coverage to low-income residents regardless of age and immigration status. Illinois and New York also cover all eligible residents regardless of immigration status.
“Minnesota is not reinventing the wheel here,” Lopez said. “And it’s important to mention that we don’t leave anybody behind. Most of these adults are essential workers that were doing the hardest, dirtiest, toughest jobs through the pandemic to keep us all safe.”
An estimated 81,000 undocumented people live in Minnesota, according to the Migration Policy Institute, a Washington, D.C., research agency. The House bill’s fiscal notes say about half of that population would be eligible for MinnesotaCare because they have an income below 200 percent of the federal poverty line.
Unidos executive director Emilia Gonzalez Avalos said the bill would allow undocumented people to access preventative healthcare and mental health services, and to build a relationship with a family doctor.
“Immigrants are not disconnected from their U.S.-born children and grandchildren. Their health is not disconnected,” Gonzalez Avalos said. “This intervention will disrupt generational exclusion and high morbidity so that workers can find out about an ailment and take care of it early and not in an emergency room.”
The Minnesota Department of Human Services estimates that about two-thirds of the undocumented population—about 54,000 people—were uninsured through the height of the COVID-19 pandemic. Despite being a health worker himself, Marco Loera Alvarez’s family was no exception.
Living with diabetes and hyperthyroidism poses daily health risks for Loera Alvarez’s father, Daniel, who lost the temporary insurance his social worker secured for him in 2006. He was able to secure the insurance under an emergency basis, but it expired after two years. Then, he had to go a few months without medication.
“We didn’t know what to do,” Loera Alvarez said. “His [insulin] levels were all over the place. It didn’t matter how much he controlled his eating habits, it wasn’t being controlled.”
He said his family relies on free clinics that provide care for undocumented people. Because his father already had a diagnosis and existing prescription, he was able to get back on his medication. If he had never gotten the initial diagnosis and prescription, the free clinic wouldn’t have been able to provide treatment.
However, Loera Alvarez said, the clinics don’t offer preventive care.
“Let’s say his diabetes or thyroid gets worse. We won’t be able to adjust medication as easily,” Loera Alvarez said. “We will have to either go to a community health clinic and hope someone is available or keep controlling it on his own.”
Without community clinics, Loera Alvarez said, his family would have been left with no options.
“There was a point where they actually were going to go back to Mexico, because it was a life-or-death situation,” Loera Alvarez said of his parents. “We unified as a family to get through it, but there was fear.”
Now, Daniel Loera is guiding his brothers and sisters, some of whom also have diabetes, through the healthcare system without insurance. One of his brothers lives in California, where he can access state health insurance, and has had far less trouble receiving care.