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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 have no way to pay for health care, they delay getting care until it’s an emergency. To make matters worse, many life-saving treatments, such as organ transplants, are only available to patients who are covered by insurance.

Right now, there are 73,000 people in Washington who can’t get health insurance because of where they were born. We are a nation of immigrants working on immigrant labor. Immigrants build our homes, grow our food, and many of them have lived in the United States most of their lives. But when they fall ill, their immigration status denies them the dignity of accessing health insurance. This year, the Washington state legislature can change that dire situation by expanding the standards for access to insurance.

I recently dealt with a tragic case that showed how not having insurance causes unnecessary pain and suffering. One of my patients has been diagnosed with an aggressive but treatable form of leukemia. She has lived and worked in the United States for 17 years and has three young children who are all US citizens. Unfortunately, despite years of working in this country, my patient was not documented and therefore ineligible for insurance at the time. Her oncology team was able to give her medication to manage the disease, but a full cure required a bone marrow transplant—a service that hospitals would not offer to uninsured or undocumented individuals.

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

There is no nuance in this matter: we sentence our neighbors to death because they were born in a different country.

Most of the undocumented workers are stuck in a tragic tragedy. The United States desperately needs them to fill essential jobs in agriculture, construction, and elderly care, but it has no legal mechanism to give them permission to do the work they’ve 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 feel when they can get insurance. Insurance means that 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 value.

Insurance also saves our state from spending on unnecessary emergency care. Working in an orchard or in a meatpacking plant is physical work that takes a toll on people’s bodies. Insurance would allow people to have regular physical exams, have screenings for cancer, and be diagnosed with kidney disease before surgery is needed.

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

It’s time for our state to recognize the reality of our workforce and expand access to insurance coverage to everyone in Washington.


The South Seattle Emerald is committed to providing space for a variety of viewpoints within our community, with the understanding that different viewpoints do not negate mutual respect among community members.

The opinions, beliefs, and viewpoints expressed by the contributors to this site do not necessarily reflect the opinions, beliefs, or views of Emerald or the official Emerald policies.


Julian Perez Family physician at Sea Mar Community Health Centers.

📸 Featured image from photobyphotoboy / Shutterstock.com.

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