Growing up as the daughter of Cuban immigrants, I was taught to always be grateful for what I had, no matter how bad things were. While this made me very humble, it kept me from critiquing many of the systems in the US, even when they didn’t work for me.
I became uninsured at the age of 18 when I lost pediatric coverage through the state and my parents couldn’t afford to add me to their employer-based insurance plan. Florida, the state I lived in, did not have an expanded Medicaid program and even though I was low-income, I wasn’t eligible at the time, due to the income cap in my state. During my experience being uninsured, I struggled to find affordable access to health care, and quality care at no cost was nonexistent. I became very ill with a chronic pain disorder and had very limited options for care. Managing a chronic illness without continuity of care and relying on sliding-scale providers was very difficult. I would bring a binder with my medical history to avoid redundant services and pay out-of-pocket when I could. It wasn’t until I was 24 that I became employed and finally gained access to affordable healthcare. I had to wait six years to gain access to a basic need–six long years of managing the best I could without a treatment plan.
This experience opened my eyes to the ways our health care system is failing people, but I felt I couldn’t share my frustrations with those around me. It made me angry that I couldn’t express how I truly felt because I grew up hearing statements like, “at least we have good quality health care” and “at least you have access to medicine.”
I was left wondering, “but do we?” As a U.S. American born in this country, I spent six years without getting a dental check-up, and coping with an unmanaged chronic pain disorder often prevented me from going to work or school. My family’s perceptions about the great opportunities in the U.S. put a burden on me. I felt that in order to respect my family and the struggles they endured to seek stability and new opportunities, I couldn’t expect anything more from our health care system.
The frustrations I felt while uninsured, and the restrictive nature of health insurance being tied to my employment, became fuel for my fire and motivated me to pursue my Master’s in Public Health at the University of Colorado.
In September 2022, I started working with Center for Health Progress as a Policy Intern. My main focus was mobilizing community outreach for the OmniSalud program, an affordable health insurance option for people who are undocumented and those with Deferred Action for Childhood Arrival (DACA) status in Colorado. OmniSalud is a result of the passage of SB20-215, a bill that created a funding source for Coloradans ineligible for Affordable Care Act (ACA) health insurance options and HB21-1232 otherwise known as the Colorado Option.
I facilitated training for Center for Health Progress staff, our community leaders, physicians and allied health care staff. Although I have a background in health education, I felt unprepared to truly break down the information in a way that’s easy to understand. Several staff members and I talked about how even the most basic health insurance terminology was inaccessible to a large part of our non-English speaking population and how unfair it was that we created a system that made it difficult to understand these terms. How did we end up with a system that was so confusing that even those “insiders” would struggle to help others to make sense of it? Did it have to be this way? How could I make this system work for everyone?
As I worked with community members to understand OmniSalud, I began to notice more and more flaws in our health care system. Even though this would expand health care access for 10,000 people, I was concerned these individuals were lacking the tools to navigate the health care system with their new insurance plans. There were also lingering fears of discrimination from providers and doubts about whether or not those enrolled would even have providers who would accept their new insurance. Another issue was there was an enrollment cap at just 10,000 individuals and that threshold was met in less than one month. It was estimated that 33,000 Coloradans would have been eligible for this program and with only 10,000 spots, it was still leaving a huge gap in access. I worried that these challenges couldn’t be addressed by my efforts alone. This was a systemic issue that needed to change if we were to truly achieve expanded access to quality health care.
More than a few crumbs
In my work with Center for Health Progress staff and in policy advocacy spaces, I kept hearing the sentiment, “we want more than crumbs, we want the whole pie.” This was essentially the opposite of what I had been told by my parents who were too scared to ask for more than the crumbs we got. But it resonated with me, and sent me on a personal reflection of my family’s experiences and dreams, the narrative I had been sold as a child, and what I believe about health care as a human right.
I was left wondering if I were to fight for the whole pie and not just a few crumbs, would I seem ungrateful for the things my family worked so hard to achieve? I am my family’s American Dream, so what more could I ask for?
In the midst of struggling with these questions, I attended Center for Health Progress’s training on Power–the first training in a series that equips our leaders to build collective power to fight for a health care system that values our humanity and wellness over profit. As we learned about the common fears that hold people back from their own power, I realized that I was afraid that my privilege–as a white, documented, U.S.-born Latina–made me unqualified to speak about the struggles of Black or Brown Coloradans who are undocumented.
Further reflection helped me realize that if I let my fear hold me back, I would be participating in a system that seeks to divide us across race and class, with the hopes that we will not build power together to fight for what we all deserve. The work I have done for the last few months has helped me understand that I have a place in this fight–and that we all do. I should be stepping into my power as a first generation American and fighting for basic human rights for myself and for others, including those without documentation. I realized that part of the American Dream is to live in a country where your basic needs are met without the fear of losing your home, your savings, or even your life. I’m determined to build collective power to transform our for-profit health care system because we deserve more than just the crumbs. We deserve the whole pie.