While many Americans are signing up for health insurance Affordable Care Act there is a large population in California that can't. Undocumented residents don't qualify for healthcare exchanges, and private insurance is often too expensive, leaving as many as one million Californians with the emergency room as their only option for medical care, and local governments are footing the bill. That's why local organizations are working to close the gap.
"When we talk about healthcare for all or health coverage for all, we need to mean it, we need to talk about all Californians," said Betsy Estudillo, California Immigrant Policy Center.
Even after the Affordable Care Act takes affect next year, California Partnership estimates about 3 to 4 million Californians will still be uninsured, one million of those will be undocumented.
"Undocumented Californians don't have many options for health coverage, they are excluded from the Affordable Care Act, they are excluded from Our California, so their options are very limited," said Estudillo.
Most go to the emergency room, costing Riverside County over $40 millions a year, according to California Partnership's study.
"It costs to go to the ER about 6 to 8 times more than receiving primary care," said Maribel Nunez, California Partnership.
Free health clinics are working to fill the need, but in Riverside County alone, the clinics can only help about 8,000 people and there is a 150,000 who are uninsured, according to California Partnership.
"They are very impacted they have very limited resources. In fact, this year, a lot of their funding was cut and potentially in the next couple of years more funding may be cut do to increasing funding do to the affordable care act, so our safety net programs are really vulnerable right now," said Estudillo.
Esperaza Sotelo is undocumented and relies on local clinics to manage her diabetes.
Through an interpreter Sotelo said she can't imagine her life if she doesn't get that help and she is nervous once the new year starts what will happen if there is not that coverage for her.
California Partnership recommends Riverside County take the money spent on ER costs and put it towards programs like free clinics.
"If we put an investment in these members of our community, we will save our county millions of dollars," said Nunez.
Why not just include undocumented residents in the Affordable Care Act? Some Republican lawmakers lobbied for it, however the President said he didn't want to reward those who have broken the law. The President also hoped to pass immigration reform by the end of the year, a move House Speaker John Boehner announced this week is not likely to happen.