When Ananias Ocampo, 76, learned that in December he’ll finally have access to health care coverage even though he lacks legal immigration status, he smiled and managed to get up from the chair next to his ice cream cart despite his trembling and extreme knee pain because of arthritis.
He could not believe it.
“Enserio, no lo puedo creer, que alivio!” cried out Ocampo while selling ice cream on the corner of 18th and Paulina streets, as he has done every day during the summer despite the COVID-19 pandemic.
Paletero Ananias Ocampo, 76, sells ice cream at 18th Street near Paulina Street in Chicago on Sept. 25, 2020. Ananias Ocampo suffers from severe arthritis, diabetes and osteoarthritis.
Paletero Ananias Ocampo, 76, sells ice cream at 18th Street near Paulina Street in Chicago on Sept. 25, 2020. Ananias Ocampo suffers from severe arthritis, diabetes and osteoarthritis. (Zbigniew Bzdak / Chicago Tribune)
He is at a high risk of contracting the virus because of his advanced age and health conditions, including diabetes. But because of his immigration status, Ocampo does not qualify for Medicare, Social Security, or any sort of federal assistance, despite paying taxes for decades.
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But in December, Ocampo will be one of hundreds of older immigrants eligible for Medicaid-like coverage in Illinois for low-income immigrants age 65 and older regardless of their immigration status. Initially, between 400 and 2,000 people are expected to sign up for the program, which was part of the state budget passed this spring.
Illinois is the first state to fully fund this type of health coverage program for noncitizen immigrant older people, according to Hayley Burgess of the National Immigration Law Center.
Leer en español: Ancianos tendrán cobertura médica en Illinois sin importar su estatus migratorio »
But the change comes as a new study shows the number of older immigrants without legal status in Illinois is expected to grow exponentially in the next 10 years. The study suggests that the expansion of health care was only a first step, said Graciela Guzman, director of the Healthy Illinois Campaign. The group has advocated for a bill that would guarantee health care for all Illinoisans regardless of income or immigration status since 2016.
“At least now I can be at peace knowing that if I get sick, I can go see a good doctor that can help me heal without having to worry about not having the money to pay for the treatment,” Ocampo said in Spanish.
Like many uninsured older immigrants, Ocampo cannot afford to isolate himself during the pandemic because he needs to work to pay for rent and groceries.
Paletero Ananias Ocampo, 76, left, sells ice cream to Ray Hernandez near 18th and Paulina streets in Chicago on Sept. 25, 2020. Ocampo suffers from severe arthritis, diabetes and osteoarthritis.
Paletero Ananias Ocampo, 76, left, sells ice cream to Ray Hernandez near 18th and Paulina streets in Chicago on Sept. 25, 2020. Ocampo suffers from severe arthritis, diabetes and osteoarthritis. (Zbigniew Bzdak / Chicago Tribune)
But this is nothing new for Ocampo, who has for decades survived paycheck to paycheck, as he became estranged from his family in Mexico because of their separation from him.
When he could no longer work at a factory because of illness about five years ago, he turned to the only job he knew he could do as he felt his knees weakening and his body trembling worsen: selling paletas, a job he had been doing for years on his days off.
He now relies on an ice cream cart to stand and walk slowly from Cafe Emmanuel, 1915 W. 19th St., to the corner where he sets up shop.
Ananias Ocampo, 76, pushes his cart along 18th Street to Paulina Street to sell ice cream in Chicago's Pilsen neighborhood on Sept. 25, 2020. Ocampo has arthritis, diabetes and osteoarthritis.
Ananias Ocampo, 76, pushes his cart along 18th Street to Paulina Street to sell ice cream in Chicago's Pilsen neighborhood on Sept. 25, 2020. Ocampo has arthritis, diabetes and osteoarthritis. (Zbigniew Bzdak / Chicago Tribune)
Since arriving in Chicago 30 years ago from Guerrero, Mexico, Ocampo has worked steadily, he said. But like many older immigrants, he sent much of his money to his parents in Mexico and was unable to save money to retire and doesn’t qualify for Social Security.
An unpublished study by Rush University Medical Center shows that the population of older immigrants with circumstances similar to Ocampo’s will “substantially” grow in Illinois in the next 10 years, said Padraic Stanley, a program coordinator at Rush who conducted the study with Chicago researcher Rob Paral.
The 65 to 74 age group should experience a twelvefold increase, while people without legal immigration status who are age 75 to 84 should increase elevenfold. That means there will be more than 55,000 older Illinoisans without legal immigration status in 2030, Stanley said.
The study, which will be published in coming weeks, finds that many immigrants came to the country during their late 20s to 40s in the 1980s, which means that they are now
reaching what, under most pension plans and Social Security, would be their retirement years.
“It ultimately shows that we need structural solutions because currently, undocumented older adults are being serviced (in health care institutions) with a patchwork of resources and people or certain organizations making exceptions to find creative solutions for patients,” Stanley said. “As the population grows, care managers, hospitals, and institutions aren’t going to be able to do as many creative solutions due to the extreme need.”
Unlike many in his situation, Ocampo has been able to rely on help from friends.
Last year, the community came together to support Ocampo after learning of his story when Marta Rios, owner of Cafe Emmanuel, shared the struggles of the men who rent her paleta carts. Rios also took on the responsibility of accompanying Ocampo to his appointments at Stroger Hospital to translate for him because he has no family members to help him, she said.
Ocampo is receiving basic medical care at Stroger thanks to CareLink, a county program that helps provide free or low-cost medical care to patients at any Cook County health facility. Though it covers many expenses, it does not cover all preventive care or costly long-term treatments to help the pain in Ocampo’s knees, to go away, he said.
That is why the Medicaid-like program taking effect in December gives him some hope.
“Maybe I can see another doctor, a specialist, figure out if I need surgery or get a treatment that might help, sooner,” Ocampo said.
Junghye Chang, 65, an immigrant from South Korea, said through an interpreter that becoming eligible for the state program has alleviated her anxiety and fear about her medical care.
Since she arrived in this country in 1996, she has realized that being treated in a hospital or seeing a doctor is expensive, so she has depended on home remedies and over-the-counter medicines.
When she does seek out a doctor, Chang often has relied on community organizations that provide medical care for those living in the country without permission to get mammograms and other preventive care.
Although the full benefits and rules for the new program are expected to be finalized by the state in mid-October, Guzman said that she hopes it will provide preventive care benefits and provide a safety net during the pandemic.
The program was championed by the Illinois Legislative Latino Caucus, in response to data showing uninsured older people who got COVID-19 could risk more severe coronavirus complications, incurring more expensive medical bills the state would end up paying, said Rep. Delia Ramirez, D-Chicago.
The expansion is expected to cost the state $5 million, said Evan Fazio, a spokesman for the Illinois Department of Healthcare and Family Services. But that’s a small amount compared to the tax contributions of the group covered, advocates say. A 2017 study found Illinois residents without legal immigration status contributed more than $758 million a year in state and local taxes, said Andrea Kovach, a senior attorney with the Shriver Center on Poverty Law, who has worked with backers of the bill.
While the program will benefit all noncitizen seniors 65 years and older below the poverty line, the majority of immigrants in that age range happen to be Latino, Ramirez said.
For now, advocates are focused on how the program will help some of those, such as Ocampo, who are most vulnerable in the coronavirus pandemic. But Guzman said they are aware of the possible challenges and the increase in cost as the population grows.
“Many of our street vendors, who are mostly undocumented elders, will finally have access to health care,” she said.
Because the program is funded by the state, it is not subject to what’s known as the public charge rule, which allows federal authorities considering applications for legalized immigration status to take into account whether someone has received federal welfare benefits, Guzman said. The enrollment for the program will begin in December, with the option to apply for retroactive coverage which will cover health care bills from the past year. Those eligible can apply through the state website and call centers.
Although Ocampo is hopeful he will now have access to better care, he fears that it is too late.
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“I worry that I won’t be able to walk anymore because I won’t be able to work, and if I don’t work, how am I going to make money to pay rent? Where am I going to live?” Ocampo said.
Carmen Velasquez, founder and retired executive director of Alivio Medical Center, which serves uninsured people in the Chicago area, said thousands of seniors who have did not have access to preventive care in their youth are now suffering the consequences.
State leaders made the right decision with the health coverage expansion but it doesn’t go far enough, Velasquez said.
“It’s the first step, but we need to get back to work aggressively on how we can go about covering more people soon,” she said.