Like many other immigrants, Mery Martinez has no legal status in the United States, no health insurance and no money. Sadly, Ms. Martinez does have leukemia, and has been struggling to find treatment for the disease, first in New York and more recently in Philadelphia. A hospital emergency room rejected her on New Year’s Day because she had not yet qualified for the state assistance that could have paid for the medical attention she needed.
With rising anxiety, and a rash that she attributed to her illness, Ms. Martinez walked into a clinic last week run by Puentes de Salud, a nonprofit group of doctors, nurses and medical students that provides primary care to Philadelphia’s undocumented, uninsured and impoverished Latino immigrants.
In a consulting room provided by the University of Pennsylvania’s medical school, Ms. Martinez, 38, who is from Honduras, was examined, given a flu shot and advised on how to navigate the health system by Spanish-speaking volunteer doctors and nurses who run the clinic two evenings a week.
Puentes de Salud, which in English means “bridges of health,” was founded to provide low-cost but quality health care and social services to the growing Latino population in South Philadelphia and began treating patients in 2006. A co-founder, Dr. Steve Larson, said the organization distinguished itself from other community-health groups by addressing the underlying causes of illness, like poor nutrition, illiteracy or urban violence.
“It’s not about me writing prescriptions,” said Dr. Larson, 53, a professor of emergency medicine at the University of Pennsylvania who said he began to develop his approach to community medicine while working in rural Nicaragua in the early 1990s. “This is an underground health system.”
While Puentes operates openly in partnership with community organizations, hospitals, universities and governmental institutions, many of the patients — like Ms. Martinez — live in fear of immigration officials.
The new federal health care law does not provide assistance to illegal immigrants, who are generally ineligible for Medicaid, cannot get federal subsidies for private insurance and cannot use the new insurance exchanges to buy unsubsidized insurance with their own money.
Under the federal Affordable Care Act, such immigrants are exempt from the requirement to have insurance. They remain eligible for certain types of emergency care under Medicaid if they have low incomes and meet other criteria, and they may receive care from free and charitable clinics in some places.
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