Starting this summer, thousands of children in Washington County became eligible for health care coverage.
The catch: Their parents are undocumented immigrants. That means, officials expect, that reaching out to these families will be difficult — thanks in large part to the level of rhetoric coming out of Washington, D.C.
At the same time that more immigrant families can receive health care coverage, the immigration policies of President Donald Trump have had a "chilling effect" on immigrants, documented or otherwise, seeking services, according to Maria Loredo, chief operating officer for the Virginia Garcia Memorial Health Center, which serves much of Washington and portions of Yamhill counties.
Last month, the Oregon Legislature passed Senate Bill 558, dubbed "Cover All Kids." It allocated $36 million in general fund dollars to the Oregon Health Authority to expand eligibility requirements for Oregon youths. And it did so while changing the definition of "eligible" from "lawfully present" youths to include any children who resident in Oregon.
An estimated 17,600 children, ages 0 to 18, became eligible statewide. It's unknown how many of them are in Washington County.
The theory: Providing regular medical care for young people — including dental, mental health and behavioral health services — is much cheaper than waiting until they are in crisis and seeing them in emergency rooms.
Senate Bill 558 was championed this year by Gov. Kate Brown. It drew bipartisan support in the legislature; one of the chief sponsors was Sen. Brian Boquist, whose district includes a swatch of Washington County.
Neither Brown nor Boquist responded to requests for interviews.
Among the champions of the bill is the Oregon Latino Health Coalition. Executive Director Alberto Moreno said his organization has been pushing for this bill for more than three years, he said.
"It's the right thing to do for these children; for all children," he said from his Portland office.
Moreno said his organization now will make the transition from bill advocate to outreach.
"This will take groups with deep relations and deep trust in the community," he said.
The coalition cited several lawmakers for pushing the bill, including Sens. Boquist and Jeff Kruse, Republicans, and Laurie Monnes Anderson and Arnie Roblan, Democrats. In the House, Moreno pointed to Republicans John Huffman and Andy Olson, as well as Democrats Teresa Alonso Leon, Diego Hernandez and Alissa Keny-Guyer.
"We have a moral obligation to support Oregonians who face disparities accessing health care," said Huffman, speaking at the Capitol in July. His district includes The Dalles. "Children rise to the top of that list."
Moreno praised the bipartisan support for the bill.
"We're proud of Oregon," Moreno said. "We're proud of these legislators."
Other supporters of the bill included Northwest Permanente, Providence Health & Services, and Children First for Oregon.
"Oregon is stronger when every child in our state has the opportunity to grow up healthy," said Dave Underriner, Providence chief executive officer, speaking in July.
One of the primary providers of pediatric services in Washington County, for immigrant and low-income families, is the Virginia Garcia Memorial Health Center. The program operates in 17 sites including Hillsboro, Cornelius and Newberg, and also at a new clinic in Beaverton (see sidebar). It's been around since 1975.
And it also operates several school-based health centers, according to Lindsay Verber, who coordinates those programs.
"We've always seen kids. Now we'll be able to see so many more because they'll have coverage," Verber said.
The center has participated in the I'm Healthy!/¡Soy Sano! program. The program is funded via a grant from the Oregon Health Authority, and provides free health care to youths younger than 19. Services are provided at each Virginia Garcia clinic and in the school-based health centers around Washington and Yamhill counties.
Passage of SB558 will provide funding for those same young people, who do not qualify for Oregon Health Plan benefits because of their family's immigration status.
With the bill's passage, the question becomes: How does the clinic reach these families?
"We're trying to find them. We're using fliers. We're looking for them," Loredo said.
As the youths get enrolled, they could receive regular checkups, childhood vaccinations, dental care, mental health care, behavioral health care — on such topics as tobacco, alcohol and drug use — and access to pharmacies.
The Virginia Garcia clinics serve 12,000 people now. Loredo said she's hoping to see that number rise to 18,000.
Kasi Woidyla, public relations officer of Virginia Garcia Memorial Foundation, said the legislation came about this year — despite a $1.6 billion shortfall at the beginning of the legislative session — because "Oregon is looking at the long game."
Preventative health care is far cheaper than waiting until there's an emergency. And, Woidyla said, "If you don't have healthy kids, you won't have healthy adults."
Loredo and Verber both said the rhetoric of the Trump campaign, and the rhetoric since he's come into office, contributed to the passage of SB 558.
"It's needed now more than ever," Loredo said.
Woidyla said walk-ins and appointments by immigrant families have declined markedly since the presidential election.
"They don't feel safe coming out. They don't send their kids," she said. "They're not involved in the (health care) services at the same level as before."
Loredo said she believes the new Oregon law will begin to change that.
"Everyone's very hopeful. Just getting the kids in early and the families not having to care about the cost is important," she said. "But first we need them to feel safe. That's so important."