If you’re not a U.S. citizen in Sacramento County and you need health care, you may go to an emergency room. Or you might find some services at clinics like WellSpace in midtown Sacramento.

"We don’t ask questions, we don’t go nosing around, we provide care," says Jonathan Porteus, CEO of WellSpace Health.

Porteus says the majority of patients at his health clinics who don't have insurance are undocumented. The network of clinics provides primary and mental health care, but for other services, it refer patients to other providers.

"It’s up to the whim of a specialist to take someone who either pays out of pocket, or gets stuff for free. We don’t have a network of specialists who are committed to that," says Porteus.

Before budget cuts in 2009, the county paid for specialty care, medication, lab tests and hospitalization for undocumented immigrants. But those benefits disappeared during the recession that reduced the county budget by 20% over one year. Current Board of Supervisors Chair Phil Serna was campaigning for a County seat at the time.

“They were looking under every stone. In some cases, they were considering cuts that weren’t even measures in the tens of thousands, they were measured in the thousands," says Serna.

Serna says now is the time for the County to consider restoring health care for the undocumented. Sales and property tax revenues are recovering.

“It’s hard for me as a member of the board, to look at some of the drastic cuts that were made, know that we have an improving revenue position, knowing that we continue to be very careful about reserves, but then not restore services where they need to be restored,” he says.

COMMUNITY MEMBERS SPEAK UP ABOUT HEALTH CARE FOR THE UNDOCUMENTED

Dozens of people showed up at a Supervisors meeting last March to talk about what restored health care for the undocumented might look like. The options ranged from offering full coverage, to contracting with providers for some services, to taking no action.

"The reason I’m here is because I’ve been working here for 10 years, I am undocumented," says Hugo Marquez, through a translator at the hearing. Marquez has two kids. He says he also has health problems – including a hernia and nerve pain.

"What most worries me, is if I am not able to continue working, how am I going to be able to be able to continue putting food on the table for my family," he says.

"I don’t earn enough to be able to pay 30 or 40 thousand dollars for a surgery," he explains in Spanish.

Former and current state lawmakers said it would be economically wise to reinstate some health care benefits, and not to wait for state policy. At least one witness was opposed ideologically - Davi Rodriguez says he represents an organization called Save Our State.

“It’s not lost on me that these people need health care. What is lost on me is why their home countries are responsible for their upkeep,” says Rodriguez.

After public testimony, Supervisor Roberta MacGlashan said the decision must be weighed in the context of other budget needs.  

“One of those being mental health and homeless. Because in the end, even though we all want to do the right thing, we have to have a way to pay for it,” says MacGlashan.

But Jonathan Porteus of Wellspace Health says even a small amount of money would make it easier to connect undocumented people to specialists.

"Getting treated means you can return to health more quickly, returning to health more quickly means that you are returning to the workforce, that you’re taking your kids to school. And you’re back in the economy that you uphold," says Porteus.

Sacramento County Supervisors will consider health care for non-citizens again this June. Advocates say other counties and state policymakers will be watching.