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Show World&Nati on Page 14 Monday, April 5, 2010 Health reform bill leaves out illegal immigrants FRESNO, Calif. (AP) - Paula Medrano shifts uncomfortably on the doctor's examination table, holding out a wrist inflamed and swollen by arthritis. The 78-year-old has no health insurance, lives below the federal poverty level, and can't pay for the medication she needs. Just days before her appointment, President Barack Obama signed, with much fanfare, a historic bill to extend health care access to 32 million currently uninsured people. But Medrano and her daughter, Juana Aguirre, barely paid attention. "It's a great thing, but it's not for us," said Aguirre. Medrano is an undocumented immigrant - one of the 7 million uninsured people living in the United States who were explicitly excluded from the legislation, according to estimates by the Congressional Budget Office. The question of whether to extend coverage to illegal immigrants was so politically contentious that, under the Great Summer Jobs in California for the largest family-owned pest control company in the US. 100% commissions up-front. Gas & cell phones paid. Check out www.ciarksummerjobs .com or call now 877-899- 1 205 4.•••••0 -40 Imam rib.• • :CLARK • PEST CONTROL :• ■ at. approved legislation, they will not even be able to buy health insurance in the newly created purchasing pools called exchanges if they pay entirely out of their own pocket. Proponents of reducing immigration believe that allowing illegal immigrants access to health care is an incentive for them to come, and an unfair tax burden on Americans. Although the approved legislation explicitly excludes undocumented immigrants from participating in the exchanges, there is no foolproof way of verifying their documentation to keep them out, said Yeh Ling-Ling, executive director of Alliance for a Sustainable USA. They will also continue to have access to emergency medical assistance. "It is not fair on struggling Americans," said Yeh. What is clear is that as the ranks of the uninsured diminish, immigrants like Medrano will continue to patch together health care as they can - at health centers such as Fresno's Clinica Sierra Vista, at hospital emergency rooms, or through programs like Healthy San Francisco, which offers universal health care to all who live in the city. "We have to be very creative - not asking for labs unless it's really essential, working with generics, working with drug companies, giving them samples," said Juan Carlos Ruvalcaba, the doctor seeing Medrano at Clinica, which charges on a sliding scale of $40 to $70, depending on the patient's ability to pay. Once an undocumented immigrant himself, Ruvalcaba was able to become a citizen and attend medical school because of an amnesty program in 1986. He remains committed to serving all patients, no matter their insurance or immigration status, but there is only so much he can do, he said. He was able to give Medrano the drugs she needed, but he asked, "What happens when they need a specialist? What if they end up in the emergency room, and end up with a big bill?" Some who work with this population are afraid that with the focus shifting onto providing care for the newly insured, those shut out of the system will be forgotten, left to fend for themselves with even fewer resources. "It may make things worse - if you say 32 million are covered, there may be less done for these large groups who are here, who are working, who are such a large part of our agriculture industry," said Norma Forbes, executive director of Fresno Healthy Communities Access Partners, a nonprofit network of eleven health care organizations in California's rural Central Valley. Illegal immigrant won't be the only uninsured left: about DR. CARLOS RUVALCABA, left, examines Paula Medrano, one of the many patients he treats, at the Clinica SierraVista Elm unit in Fresno, Calif., in this photo taken Thursday, March 25. Medrano is an undocumented immigrant - one of seven million uninsured people living in the U.S. who were explicitly excluded from the legislation, according to estimates by the Congressional Budget Office. AP photo 16 million Americans are estimated to remain outside the health care system even after access is expanded over the next few years, according to the Congressional Budget Office. This includes those who opt out, who don't know how to enroll, or who are exempted from the health insurance requirement because they can't afford the premiums, even with a subsidy. For these patients, there will indeed be fewer options as doctors, hospitals and other providers increase their caseload to take in new patients bearing insurance, said Dan Hawkins, who is charged with policy and research at the National Association of Community Health Centers. "There will be greater concentration of care for the uninsured in fewer places," Hawkins said. Community health centers, the lynchpin of the safety net system now caring for the medically underserved, whether they are immigrants or citizens, will remain one of the places where people like Medrano will be able to see a doctor at an affordable cost. Federally qualified clinics got a substantial funding boost through the health reform package. They will get $11 billion in new funding over the next five years, which will allow them to double the number of patients they see, from 20 million a year now to 40 million people a year by 2015. Most of these new patients will come bearing new insurance cards, or be part of the larger pool qualifying for Medicaid. But among them will be illegal immigrants, said Hawkins. Top republican lawmakers criticize RNC WASHINGTON (AP) - Two top congressional Republicans said Sunday the Republican National Committee must be held accountable for the way it uses the money it raises in light of nearly $2,000 spent for a night at a sex-themed Hollywood nightclub. "This kind of thing has got to stop or they won't get any contributions," said Sen. Jon Kyl of Arizona, the No. 2 Republican in the Senate. Kyl and Rep. Kevin McCarthy of California, who is leading the GOP effort to recruit candidates and elect House members, distanced themselves from RNC Chairman Michael Steele when discussing the committee's controversial spending. 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After reporters noted the bill in a funding report, the RNC fired a staffer it blamed for the outing and said it would be reimbursed by a donor who had attended. Asked on "Fox News Sunday" if Steele should step down, Kyl demurred but said, "The people that contribute to the committees, both Democrat and Republican, want to know that their money is well spent for the cause, and it needs to be that way." McCarthy, appearing on the same show, sidestepped the question of whether Steele has his full confidence. "The RNC does have some challenges that they need to correct. Not only does the American people request it but the Republicans requested it as well," McCarthy said. "If we are going to show ... the American public that we believe in accountability and bringing it back to Washington, we have to make sure that the RNC has the accountability just the same." He added: "I think Michael Steele has worked very hard. I think when you find the challenges going forward that you heard in the last week ... he's trying to correct it. But you've got to bring the trust back, and that may mean shaking some other roles inside the RNC as well." Quake: Baja California rocked by 7.2 quake continued from page 2 in San Felipe, on the Gulf of California, but there was no damage, said receptionist Araceli Marquez. Seismologists said there have been many earthquakes in the region including many in the magnitude-3.0 range before Sunday's big shock. "The last time we had an earthquake this large in either Baja or California was in 1992 with the Landers Earthquake, which was 7.3," Jones said. The USGS reported three strong aftershocks within the hour, including a magnitude-5.1 jolt in the Imperial County desert east of San Diego. Magnitude-4.5 and magnitude-4.3 aftershocks were also reported. Another occurred off Malibu. The 7.2-magnitude quake was felt as far north as Santa Barbara, USGS seismologist Susan Potter said. It was one of the strongest to hit California in recent history. Only one has been stronger - a 7.3 quake that hit Landers, Calif., and left three dead in 1992 - and there were at least two other 7.2-magnitude quakes in the last 20 years. Seismologists also said a number of small quakes were triggered in a geothermal area in Northern California. More than 5,000 Southern California Edison customers were affected, mostly with about 30 seconds of flickering lights. Several hundred had longer outages. In Arizona, 3,369 customers in the Yuma area had a "relatively momentary outage" from the quake, Arizona Public Service Company spokesman Don Wool said. Only about 70 people were still without service in the rural Gadsden and Summerton areas. But Wool said he expected electricity to be restored there in about two hours. Clint Norred, a spokesman for the Yuma, Ariz., Police Department, said the quake was very strong there but he'd heard no reports of injuries or major damage. In the Phoenix area, Jacqueline Land said her kingsized bed in her second-floor apartment felt like a boat gently swaying on the ocean. "I thought to myself, 'That can't be an earthquake. I'm in Arizona,"' the Northern California native said. - Answers To Today's Crossword Puzzle! Super Crossword Answers DOOM DOOR DAMN MAMBO MOM MODO DOOM MOOD MUUMOOMMO MOODM MUM MUM] IMMO OEM MOO MOM BOOM DOODMOO MUMMUUMMOMOM MOOR MOM MOOD ODOM MOM =MODE OOMMODO MEMO MODEM ODOM =OMB MOM MOOED ODOM DEO MOM MEDMMODOM MOOMMODOO MOOD HMO MONO DMAMM MOO ODOM MODOM DOOM MOM BOMOUDO ODMOOM =MOO =MOM MOO DOD OMOM MODBODOODOMO MOOMDEE MIDI MEDD DOM MOM MOOD MOO= MAMBO MEMO MOMMBOUOM MOOR MOM ODOM MOM =MOO ODOM MEMO EOM 7 j 6 9 8 www.a-bay-usu.com ClassifiedMiS Utah State University • ogan, Utah • Students... Going away for the summer?... 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