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Advocates Celebrate Prenatal Care Expansion

Funding expansion of the Citizen Alien Waived Emergent Medical program was the result of a 10-year effort
September 25, 2013


September 25, 2013 – About 100 people gathered Wednesday morning to drink coffee, eat a light breakfast and celebrate the expansion of prenatal care under the Citizen Alien Waived Emergent Medical program to all women in the state – a victory advocates said was the result of a 10-year battle fought on multiple fronts.

“It took many people. It took many years,” said Linda Roman, health equity policy coordinator for the Oregon Latino Health Coalition, which hosted the event.

“Women hold up at least half the sky, in my book, and we want to make sure they get the care that they need,” said Alberto Moreno, executive director of the coalition.

Later, he said, “Keep in mind that the child we're providing care for, when they're born, they're going to be what?” The audience responded: “Citizens.”

Moreno presented a painting of a child to the Oregon Primary Care Association to help the organization decorate its new, larger office. He also presented plaques to several partners, and a commissioned painting to Rep. Alissa Keny-Guyer (D-Portland), who fought for the funding to expand Citizen Alien Waived Emergent Medical funding to cover prenatal care statewide. Previously, the program – which allows people to access care without having to provide citizenship documentation, a requirement of many healthcare programs for low-income people – was only available in 15 of Oregon's more populous counties.

Sisulak praised the legislators who championed funding, as well as Oregon Health Authority director Bruce Goldberg. It was the legislators whose efforts led to the expansion of prenatal care, despite the risk it posed to their political careers.

Kasey Jama, the executive director of the Center for Intercultural Organizing, stressed that expanding access to prenatal care does not just affect Latino communities, but is relevant to immigrant and refugee families from other parts of the world as well. He talked about a hospital he visited in Somalia, where he never saw people being asked for documentation when they tried to access care, and stressed the need for universal care.
“It's a moral issue. It's a human right, basic principle and that's what's lacking in this country,” Jama said.

“We're going to fight hard, we're going to push hard, and we're going to get to a space where this state can be an example for this country,” Jama said.

“Our justice-seeking will literally be carried forward in the DNA of the children who will benefit from this program,” Moreno said. Those children will be born healthier, go to school ready to learn and have better health outcomes and employment opportunities as adults, he added.

“You can imagine how many unkind responses we received about these children,” Moreno said, adding that one legislator told him, “If you want to walk up and down the halls of the Capitol screaming that we're not providing care to illegal children, be my guest.”

Moreno and other advocates began working to secure more funding for prenatal care 10 years ago while he was still working for the state, and tried various means, including administrative action, a county-by-county rollout and leveraging private funding.
“What made the difference was Rep. Keny-Guyer following me and saying, 'I want to help,'” Moreno said. “She had nothing to win.”

Moreno then presented a painting he'd commissioned portraying three women holding one baby: one of the women was his mother, one was his grandmother and the other was Keny-Guyer. The painting was inspired by the idea that “it takes a community to raise our children,” Moreno said.

Teary-eyed, Keny-Guyer talked about her childhood experiences traveling with her father, who worked for Save the Children, working with refugee women in Pakistan who were unable to feed their children, and her own experience with illness in Indonesia, where she lived for three years as a young adult. There, she had difficulty navigating the healthcare system due to the language barrier. Finally, she talked about her experience of pregnancy, and how, as an expecting mother, “You worry about every kick.”

Goldberg said the prenatal care expansion is part of a set of changes that will expand care for low-income people in Oregon, and the state needs to keep moving to expand care.

“I fervently believe that all of us, regardless of who we are, have a right to basic healthcare,” Goldberg said. Both the prenatal care expansion and state transformation efforts were part of an effort to “change the way we do business, from only taking care of people when they're sick, to trying to keep people healthy.”

Rep. Joe Gallegos, D-Hillsboro, said while many speakers had emphasized the experiences and concerns of pregnant women, it's important to remember that fathers are also affected by the lack of access to prenatal care. His 24-year-old daughter was born prematurely, and he’s lost two children to premature birth. To this day, Gallegos wonders what they might have become. Then, in Spanish, then English, he said, “The struggle for justice is lifelong.”

The final speaker, Victoria Lara, chief executive officer of Lara Media Services, a Portland public relations firm, talked about her daughter, also named Victoria, died before her first birthday due to complex health issues. “Victoria showed me that we have to continue fighting. It's so important.”


Christen McCurdy can be reached at [email protected].