Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform

4. Other Access and Barriers to Health Care

90 Other Access and Barriers to Health Care Guadalupe is a hearty Mexican woman with round features. She is very soft spoken and shy; her smile is warm and welcoming. Originally from Durango, Mexico, where her other siblings still live, she has been residing for the past ten years in the sparsely populated, rural, dry climate of eastern Oregon with her husband and eight children. Only three of her eight children were born in the United States, leaving the oldest five, along with Guadalupe and her husband, undocumented. Her community, which has a population of about 1,700 people, lies in a remote stretch of Oregon. The closest town with any range of services is about thirty minutes away. The Latino population in this area is about 25 percent, which is significantly higher than the state average of 8 percent, in large part because of seasonal employment opportunities in the agricultural sector. In general, when trying to map out directions to respondents’ homes, Internet sites like Mapquest.com make things blissfully easy. Unfortunately, Guadalupe’s pastoral town was apparently too small for Mapquest to bother mapping. Asking locals for help resulted in being pointed in a vague direction, but we managed to stumble upon Guadalupe’s trailer after a couple of wrong turns. This task proved even more difficult at the second interview that was scheduled for 10 P.M. after a hard day’s work. At that visit, the unlit gravel roads made it necessary for Guadalupe’s daughter to pick us up at the local gas station and drive us to her trailer. The first time we visited Guadalupe, we caught a glimpse of several darkhaired heads bobbing up and down in the main window of the trailer as we Chapter 4 Other Access and Barriers to Health Care 91 pulled up. Guadalupe answered the door and humbly welcomed us into her modest home. Passing through the entryway that also served as a small laundry room, we saw a molcajete (a handmade stone mortar and pestle) with fresh salsa on the small kitchen table and a sack of apples overflowing on the floor. It was apple-picking season. Guadalupe proceeded to walk us through the kitchen and into the living room. Four children, with hands folded on their laps, quietly and eagerly watched from underneath the kitchen counter. They introduced themselves one by one, each of their names beginning with the letter “G,” just like their mother’s. We sat on the other worn couch just opposite the kids and began chatting. One by one the children quietly slipped outside to play after the interview began. We conducted the interviews in her native Spanish because Guadalupe spoke very little English. We talked about her employment opportunities, and she confessed that they were extremely limited because she does not have a “good” social security card. Guadalupe is an undocumented worker. Her eldest daughter, who at sixteen has lived three-quarters of her life in the United States, is also undocumented and has just started working in the fields during the summers . Her husband also works in the fields, but year-round, which provides some degree of stability for the family. When I asked if the farm labor was hard, she replied, “A little, but, yeah, you have to endure it.” Because Guadalupe is undocumented, she is eligible for only minimal social services from the state and federal government. In fact, the only reason she is eligible at all is because three of her eight children were born in the United States and, as citizens, are eligible to apply for services like TANF and OHP/ Medicaid. When she does receive TANF from the state, the amount covers only the three qualifying children, which for a family of ten does not go a long way. When Guadalupe applies for OHP/Medicaid, her three youngest get full coverage , but she, her husband, and other five children only qualify for “emergency” coverage, an OHP provision that allows undocumented workers coverage for emergency room visits. At the time of the first interview, her three youngest had full coverage, but she was unsure about the status of the rest of the family because she had not received their medical cards by mail. She assumed they were not covered, but did not know for sure, and did not seem to understand how to check on their status. At the same time, she felt like the emergency coverage was worthless anyway: “But it didn...