After losing a family member to cancer, Waite Park advocate hopes new MinnesotaCare access for undocumented residents will save lives

Ma Elena Gutierrez remembers the joy her brother-in-law, Julian Chavez, brought to her family.

He was an immigrant from Mexico who came to the U.S. around 20 years ago. He died in August of 2021 – only 11 months after the doctors told him he had stage 4 cancer. He had three children.

Chavez was undocumented and worked on a farm in St. Martin, Minnesota. For many undocumented Minnesotans, visits to the doctor’s office, especially for preventative care, is just not possible.

“We have people that die because they didn’t have insurance and because they were working so hard, so many hours. My brother-in-law was working 16 hours a day, six days a week,” Gutierrez said.

In September of the previous year, his vision got blurry, and he had a headache, so his wife took him to the hospital in Paynesville. Once he got there, they wanted to ambulance him to St. Cloud.

“He was thinking about the money. How expensive will it be if he goes on the ambulance?” Gutierrez said.

His wife drove him instead. The doctors in St. Cloud diagnosed him with stage 4 cancer in his brain and estimated he would have 18 months left to live. He passed away seven months earlier than that.

“It was very painful … You know how when you get an injury and you have a scar? It seems like I have that because if we had insurance before that, people would be here,” Gutierrez said.

Pain brings forward change

Gutierrez’s brother-in-law wasn’t the first death she’d seen due to people not having insurance and not going to the doctors frequently.

Around four years ago, she got a call from an old friend she had worked with in a restaurant. He had been living in the U.S. for 20 years, was undocumented, and hadn’t had a formal doctor’s appointment once that entire time, she said.

He had gone to a mobile clinic, where they said he might have cancer. But they needed to run tests somewhere else to confirm. He then went to a doctor in St. Cloud and discovered he had cancer.

Gutierrez didn’t recall the stage, but her friend died six months after the diagnosis.

“That was painful to me to see,” she said.

After seeing that, she realized her community had a big need. She was active in one of the churches in Waite Park, where she quickly became the person that others went to when looking for health care resources.

“People were calling me to ask me what they could do because they were feeling sick for many days, and some of them were afraid to go to the doctor,” she said.

So Gutierrez led efforts to help Hispanic people with their health care needs at a clinic in Waite Park associated with Unidos MN, an advocacy group working to advance social, racial and economic justice. It started before the pandemic, but it closed down for a short period of time before opening again.

“I was thinking if the hospitals and the clinics are open, why don’t we have the clinic here open? Because our community, we don’t have insurance, and now COVID is hitting our community,” said Gutierrez, who now directs a program called Fe y Justicia (which means “faith and justice”) that’s part of Unidos MN’s work in central Minnesota.

Doctors, nurses and students volunteer at the clinic, and services, like tests and prescriptions, are free. Gutierrez said three to four doctors are at each clinic, and see anywhere from 30 to 50 patients. People come in to receive vaccinations, check their blood pressure, or have a visit with a doctor.

“Our clinic has been saving people from the more aggressive (illnesses). It’s been preventing people from going to the emergency room,” she said.

Minnesota to address the barriers

Gutierrez said for many people who come to the clinic, the risk of potentially being deported was not worth going to the doctor’s office. She said fear heightened during Trump’s presidency when border patrol arrests increased.

Having the ability to pay out of pocket, too, is another difficulty.

“Our people don’t make a lot of money. And if they go to the doctor, they get a bill for $400 or $600, or it can be a high bill if they go to the emergency room. Sometimes it’s because they don’t have money to pay to go to the doctor … Their whole check will go to their appointment,” she said.

While community efforts like free clinics give some level of care to undocumented people, there are still many things it cannot help with.

One woman goes to the clinic to get her diabetes medication every month. But the doctors there told her she needed more specialized care to manage her chronic condition, which she can’t afford out of pocket.

Now, new Minnesota legislation seeks to remove that cost barrier of paying out of pocket.

The recently passed health omnibus bill allows undocumented people to be eligible for the MinnesotaCare public option.

This bill will improve the health of undocumented Minnesotans, said Rep. Tina Liebling, DFL-Rochester, a chief author of the health budget bill. Minnesota previously had some emergency medical services programs that offered coverage for undocumented people, but only in life-or-death situations.

“I think Democrats, one of our core principles is that we believe everybody should have access to health care,” Liebling said. “It’s been kind of in the progressive community for quite some time that this would be a good thing to do.”

The Senate version of the bill only expanded access to undocumented children under 19 years old, while the House version included all undocumented people. Lawmakers negotiated during conference committee and ultimately agreed on a bill that allows all undocumented people, including adults, to apply for MinnesotaCare.

The state aims to begin enrolling undocumented immigrants in MinnesotaCare by 2025 – giving them the same premiums paid by other Minnesotans at the same income level.

Around 300,000 Minnesotans were uninsured in 2022 and about 17%, or 51,000, are undocumented immigrants, according to the Department of Human Services.

“Covering people who are undocumented or at least letting them be eligible for the MinnesotaCare program on the same basis as everyone else is just a huge step forward,” Liebling said. “I think it’s good for the entire state, not only for people who will now have health coverage for the first time, but I think that when people can get access to health care, it helps everybody.”

The bill passed in May after a lobbying effort led by Unidos MN, with advocates and community members like Gutierrez providing testimony. For her, the passing of this is a look into what faith and justice might look like for her community.

“My brother-in-law left three kids behind with his wife, and it’s hard. It’s hard. The time that we spent in the Capitol we were spending with a lot of hope. We were spending because we have a dream for our people to be better, to be healthy,” she said. “We cannot change the past, but we can change the future.”

Editor’s note: This story has been updated to clarify that the Waite Park clinic and Fe y Justicia is part of the organization Unidos MN’s work in central Minnesota and to clarify Unidos MN’s role in pushing for the bill at the Capitol.