The employee does not have documents, health insurance, or have government benefits if she becomes ill.

Emma is 60 years old and her plans to retire are not very clear. The home health care worker is undocumented. Although you are part of the United States workforce and contribute your taxes, the moment you stop working, you will not receive any financial aid for your retirement.

Her concerns at work have been on the rise lately as the new coronavirus COVID-19 continues to spread.

Emma, ​​who declined to provide her last name for her safety, is originally from the Philippines and immigrated to the United States when she was 48 years old. For more than 10 years she has worked as a caregiver for sick or elderly people. He currently cares for a 91-year-old woman. An agency that hired her pays her $ 165.50 a day and stays at her client's house five days a week.

Although you should be working an eight hour shift, that is not the reality as you have to take care of your client day and night.

"There is no such thing as rest for us caregivers, because even if we are asleep, our ears are open to any movement or noise … you have to be alert 24 hours a day," said the worker.

Emma expressed that she is very careful when she is with her client. “I take care of myself with proper hygiene, like washing my hands. I always wear gloves, even before the coronavirus, because my clients provide them for me. ”

She added that she must be in perfect health at all times, otherwise she could infect her client, whose age makes her very vulnerable to any infection.

"If you cough or have a fever, she can get it easily and I don't want that because this (job) is my only means of survival," said Emma.

The spread of the coronavirus has affected millions of workers who were laid off or lost their jobs due to government orders to stay home. However, workers like Emma are exempt from the order as their work is considered "essential".

Despite being a health worker, Emma does not have health insurance or paid sick leave.

Pro-immigrant activists argue that the United States' medical system must provide affordable health care to undocumented immigrants, especially at a time when the country is facing a pandemic. And they advocate paid time off for home caregivers who work with clients who are already sick and vulnerable to infection.

"Most of the undocumented population is middle-aged," said Héctor Plascencia-Juárez, organizer and policy advocate for the California-based # Health4All campaign. "Regardless of age or immigration status, diseases do not discriminate."

Emma says she has not needed to ask for days off.

However, she diligently follows her own preventive care regimen. Before the pandemic, she would take the bus and train from her home to her client's home. The trip of around an hour cost him about $ 3 one way and / or one of coming.

To avoid contact with people after the outbreak began, Emma began taking a ridesharing service, at a cost of about $ 37 each way, a cost she absorbs.

"The problem with this virus is that we don't know who is infected," said Emma, ​​who lives alone in a small guest house.

She said she pays a very cheap rent since she practically stays there only two days a week. She arrives at her client's house on Friday morning and returns home on Wednesday morning.

“When I return to work after my days off, I carry (my uniform) in a bag. When I get to work, I immediately change into my uniform, "said Emma.

When it comes to her own health, Emma said she drinks a mixture of ginger, turmeric, cinnamon, and honey in a cup of warm water.

"This prevents you from getting sick. So I take this almost every day, "he explained. "Apart from this, I am taking vitamin C and my regular supplements."

Emma acknowledges that she must take great care of herself alone in this country. Like many other undocumented health workers, she has no health insurance and is excluded from government aid.

"So what we can only do is not get sick because when we get sick no one will take care of us," said the worker.

Getting sick would be expensive in other ways for Emma and other home health care workers. Most do not have employer-provided paid sick leave and are not automatically covered by the recently passed Families First Federal Coronavirus Response Act. This measure establishes up to two weeks of paid sick leave to encourage employees to stay home when they become ill by providing them with a financial mattress.

However, many workers are not fully covered by the new sick leave provisions, including large business workers with more than 500 employees, small business workers with less than 50 employees, as well as healthcare providers and first aid, explained Elisa Minoff, senior policy analyst at the Center for Social Policy Studies.

"This means that employers, at their discretion, may deny sick leave to workers in the health care field," said Minoff.

Another option that could help Emma was announced Monday by California Insurance Commissioner Ricardo Lara.

The commissioner informed insurance companies that all California workers affected by COVID-19 on the job are eligible for workers' compensation benefits, regardless of their immigration status.

This includes workers engaged in first-response occupations, such as medical care, emergency services, food production, sales and deliveries, among others.

"This unprecedented pandemic has raised questions and concerns among essential workers in the immigrant community who report to work every day and offer us vital goods and services," Lara said in a statement. "Worker Californians who are exposed to COVID-19 are entitled to workers' compensation benefits if they become ill, regardless of their immigration status."

Unexpected diagnosis

Emma has seen how much health insurance can help when a crisis arises and how costly it is to be without it.

In 2009, Emma was diagnosed with stage 1 breast cancer after a regular mammogram.

"I didn't feel the (little ball) or anything, but the mammogram detected it," said the worker. "It is difficult because when they tell you 'cancer' you think you are going to die and I am alone in this country.

Emma was referred to the Harbor-UCLA Medical Center in Torrance. A social worker there helped her with paperwork and was able to receive emergency Medi-Cal, the temporary health insurance that is given to low-income and uninsured people during medical emergencies.

Emma said that because her cancer was detected early and was considered an emergency, she was able to start her treatment right away.

He underwent lumpectomy surgery, where only the tumor was removed without removing the breast, and subsequently received four chemotherapy sessions, 33 radiation sessions, and the ovaries were removed, all at no cost to his pocket. She estimated the total value of the care to be more than $ 100,000.

Emma said she feels very fortunate to have received her health treatment on time, something that doesn't happen often in the undocumented community.

A few years later, he had a painful back injury, but did not qualify as an emergency and therefore did not obtain the emergency Medi-Cal. Without insurance, he ended up with a debt of $ 7,000 for his medical care and time he didn't work, a crushing burden on his modest income.

It was that experience that made Emma an activist fighting for the expansion of health care for the undocumented. And she's especially passionate about the subject now that the world is facing COVID-19.

"There are many undocumented people like me who don't get the same benefits, even if we work the same or much more," said Emma. "So I think if I can be that little voice that can open the eyes and ears of legislators, I will."

In her spare time Emma is dedicated to advocating for the health of undocumented workers. (Jacqueline García / La Opinion)

The Affordable Care Act (ACA) allows families to obtain affordable health insurance, but excludes undocumented immigrants.

Undocumented immigrants are excluded from access to the ACA's state insurance exchange, known as Covered California, to purchase coverage with their own money.

Each county and city has its own policy to offer health care services to undocumented immigrants.

During the coronavirus pandemic, hospitals and clinics or doctors may identify COVID-19 treatment as an emergency treatment, which would be covered under emergency Medi-Cal, according to the Los Angeles County Department of Public Social Services.

The Trump administration recently expanded a rule that blocks the path to citizenship for immigrants who have benefited from Medicaid, food stamps or federally subsidized housing.

In light of the pandemic, the United States Citizenship and Immigration Services recently relaxed the so-called "public charge rule" and stated that any evidence of preventive services or health treatment related to COVID-19 will not be considered as future public charge test for immigrants.

"So if you are concerned, you think you may be sick or want to access health care services, even if you are not sick, but you are concerned about the pandemic the world is experiencing right now …" said Daniel Sharp, chief recently from the Los Angeles County Office of Immigrant Affairs. "In the future, when you apply for immigration status, this will not count against you in any future public charge test."

Advocating for health

In 2019, Emma shared her story in the documentary “CoverAge” by filmmaker Set Hernández-Rongkilyo, a young undocumented DACA beneficiary. Emma currently volunteers at the Pilipino Workers Center, where she informs others about health coverage options for the undocumented.

Emma said that her relatives in the Philippines are impressed with the change she has had since becoming involved in activism.

"During the coronavirus, all I can do is take good care of myself," said Emma.

The CoverAge documentary will air live online on April 29, 2020 followed by a discussion about expanding healthcare for the undocumented. You can confirm your attendance here to receive the link to the movie:

Additional Information:

If you or someone you know is undocumented and is seeking medical services during the pandemic, the following agencies can help you:

Los Angeles County Office of Immigrant Affairs (OIA)

Tel: 1-800-593-8222


My Health LA

Tel: (844) 744-6452


Emergency / Restricted Medi-Cal

Tel: (866) 613-3777


For information on workers compensation:

This project is the result of an innovative journalism endeavor — The USC Center for Health Journalism Collaborative — that includes a variety of media outlets from across the state of California dedicated to presenting joint reports on the state's uninsured individuals. News media include newspapers from Gannett Co., McClatchy Corp., La Opinion, and Southern California News Group, as well as broadcasters Capital Public Radio and Univision.


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