Between Two Crisis Points: Los Angeles County, Undocumented Healthcare, and Emergency Settings in the 1970s and 1980s

Nic Ramos, Brown University

It is well known that undocumented immigrants have been permitted to seek care without fear of deportation in emergency settings since the passage of President Reagan’s landmark 1986 Emergency Medicine Training and Labor Act (EMTALA). It is less known, however, how Los Angeles – the county with the largest percentage of unauthorized entrants in the U.S by the 1980s – affirmatively committed resources to undocumented healthcare in preventative settings from at least 1971 to 1981. Scholars also have overlooked the impact of Amnesty, or the Immigration Reform Control Act (IRCA), on Los Angeles’ public health budget -- passed just a few months after EMTALA in 1986 – which threatened to overload the county’s clinic system with newly naturalized patients while also continued to commit the county to emergency room funding for migrants ineligible for amnesty. Such budget crises have led to what scholars now refer to as health “safety nets” – public health services pinned to emergency room settings. Using documents, newspapers, and reports related to undocumented healthcare in Los Angeles County, this paper explores the public rhetoric around undocumented healthcare in 1981, when Los Angeles County shifted undocumented health resources from preventative health clinics to emergency rooms, and in 1986, when the twin legislations of Amnesty and IRCA threatened to undermine Los Angeles’ public health system entirely. By drawing the connections between these two crisis points, the paper illuminates how public officials, both liberal and conservative, crafted new narratives around the important role undocumented migrants played within the city’s new economy. Despite this shared discourse around the value of undocumented labor to the city’s global status, the paper illuminates how the predominance of emergency medicine and its deployment to undocumented citizens underwrote citizen fears of public safety and welfare dependence associated with a growing so-called underclass.

No extended abstract or paper available

 Presented in Session 46. Health Crossing Borders and Barriers: Latina/o, Immigrant, and Migrant Access to Health Care