[MUSIC] Hello today we have with us, US congressman Mark PC 33 of the 33rd district of Texas. Thank you so much for being here with us today. Good to be with you all, Buenos Dias. >> [LAUGH] So we have a few questions we'd like to talk to you about today. The first one is how would you describe the major issues and barriers that impact the health of immigrant persons, families and communities in your district? And related to that, how are other individuals or stakeholders are impacted by these issues? >> Yeah, well, first of all I don't know if you're aware but I have the highest uninsured rate of any congressional district in the country. Roughly about a third of the constituents that I represent are uninsured and a big percentage of that is of the undocumented population. One of the ways that the undocumented population has been served has been through federally qualified health care centers and through emergency room use at public hospitals. And then you have a combination of things that are happening. First some of the, as we have heard about jobs that a lot of people don't want there are a lot of jobs and things like, let's say, food processing, there's a huge food processing plant, a couple of them in Dallas. And you have a number of people that are in the undocumented population that work at jobs like that and they do have insurance on those jobs. And oftentimes they are able to go and have their health care needs met at the federally qualified health care center. But then you have other individuals and families that work jobs where they don't have any kind of health care benefits and they are not eligible to apply for the Affordable Care Act. And it definitely puts a strain on the families and on the public health care system. Because, and even at the federally qualified health care centers where people don't understand is that they have to market themselves to be able to have a certain number of people that are ensured that are using those facilities. Once they are too reliant on what they call self pay, they really become unsustainable. And so for people in the undocumented community in particular, being able to utilize one of those two facilities, either FQHC or either a one of our public health care systems is beneficial, but crucial for these families to be able to maintain their health. >> So it sounds like you're saying that when there's too high of a uninsured population, it really kind of breaks down the whole system for everyone, because it relies on a certain percentage of people being insured. >> Right yeah, a lot of people don't realize that for our public health care system, whether it's federal, qualified health care center or whether it's a public hospital, they still need for people to come in that have insurance. Whether it's Medicare or Medicaid, they need, like a certain percentage of people to come in there that have health care insurance. Because once it reaches a certain percentage and a self pay, then it just really, it becomes unsustainable. There's only so much that they're able to write off and and a loss, and they have to start really scurrying for where they're going to get these excess funds to be able to pay for health care. We are we actually, because in here in Tarrant County, because I represent Dallas and Fort Worth and Tarrant County is where Fort Worth is located. And in Fort Worth, we actually almost lost several of our federally qualified health care centers because they were too heavily self pay. And it would have been devastating not just for the community, but it also would have been devastating for the people that live in these communities that really rely on these federally qualified health care centers. Because they have bilingual staff there, there's a level of comfort ability and going to some a smaller place in your neighborhood versus go into one of the larger healthcare systems like Parkland or like John Peter Smith over here in Fort Worth. And it would have put a strain on JPS. And it would also put a strain on these communities and families if those federally qualified health care centers would have closed. And so luckily we were able to avert a major disaster. But coming up with solutions like that to be able to meet the needs of the undocumented, I think are really going to be key from here moving forward in communities, particularly where you have fast growth communities like here in the North Texas area where we added about a million new people. If you look at the, at the census, there about a million new people that decided to call the Dallas Fort Worth area home since the last census was taken. I mean you're going to, the fact of the matter is that you have to figure out how in the world you're going to serve these new people that are coming. Again to work these jobs that people don't think about jobs, maybe even in health care and menial related jobs and food services and hospitality and agriculture. Because as our population grows and we have more businesses this were very reliant on this population to be able to help our economy grow. And we're kind of in it together and so being able to find healthcare solutions for these communities I think are just crucially important. >> Yes, so to kind of circle back to what you're talking about, how you almost lost the programs, could you speak a little bit too what you did to to rescue them? >> Yeah we pulled- >> [INAUDIBLE] >> Yeah yeah absolutely, we pulled together everyone in the health care community, whether they were private, whether they were non profit or whether they were government related and told them that we have to figure out a way how to get some additional funds for our FQHC. And I think that the public hospital in Tarrant County understood that it was important and so they wanted to work with them as well. And then we were able to eventually get more money from the federal government to help keep the doors open. And that was really the key. Otherwise we would have if you look at the Dallas Fort Worth Metroplex, we have talked about that million plus people that we added. Texas was again probably when it comes to the we're looking at what the lowest population increased we've had since the 1930s. And so now the United States is basically in a competition with other states to see how you can attract jobs and people in the population basis not growing a lot. And so, we were very fortunate that we experienced a lot of growth. And so I talked about that million plus people that we added. Here in the Dallas Fort Worth Metroplex with all was also going to be interesting to see once the census numbers come out or how many more people in the Dallas Fort Worth Metroplex are uninsured with that population growth job loss because of COVID 19, different factors like that. We have about a million people also according to the last census that in Dallas or that don't have health care insurance, so also making us one of the largest metropolitan areas in the country of uninsured. And you can imagine had we lost some of those services, just the strain that would have put on the public health care system for them to be able to find additional money, additional funds to be able to treat all of these individuals. It would have been just, it would have been terrible and it just really would have set us back. We have to figure out how we're going to address the needs of an area that if you look at the projections here again, while the growth rate for the United States is probably going to continue to stay flat when it comes to growth here in the North Texas area where we're still planning on experiencing a lot. This is the place where people are coming for a lot of different reasons, but we have to figure this out as we continue to grow or people will eventually stop coming because health care is such an essential need for individuals and families. That is, I think is going to be important for the players here in the Metroplex. The next from now, the next 10, 20, 30 years to really come up with something sustainable, that's going to work. If the federal government doesn't come up with something that can be a prescription for the entire country. >> Well, moving on to the next question, how well do our current policies respond to these issues at the federal, state and local level? You addressed this a little bit already, but if you want to add something to the and so this could include the past policies and the current policy proposals. So if there's anything you'd like to add that you haven't already, so. >> Yeah, I think the current system responds. What, I think one of the flaws in the current system is that it responds based on emergencies and not necessarily projections and where we should be responding based on projections. Again, I talked about the growth that we're expecting here and that was what was Metroplex over the next, from now until the next,10, 20, 30 years, what are we doing to address those needs? What are we doing is we have a larger population of people that are what we would consider, poor working class, not upper middle class, but maybe they're defined as as, as middle class, but really they're they're struggling to make ends meet as that population grows out in suburban areas. We're starting to see a lot of poverty and a lot more middle class families moved further and further out. The same way wealthy people there back in the 1970s and 80s, so how are we going to have those needs met of those healthcare needs? Metformin from individuals, as we see populations move out in the suburbs, exurbs, and even rural areas and again, trying to address that now, instead of waiting for the next disaster to happen or there to be an outbreak. I think that looking at ways that we can come up with solutions and money is the way to fix that now. One of the ways that Texas can fix that and that we haven't done is that, we're one of the only big states that have not expanded Medicaid. I don't know why our governor is living in 2000 and nine and why he's living in 2009 and why leaving in 2010 are really don't, I mean, I think the whole, we can't let expand Medicaid because it would make Obamacare look like it was a success. Like I don't think that people, I think in politics, I think people's memories are really short and I don't think that's quite honestly, if I can be blunt, I think that that's actually stupid too. Decide not to expand Medicaid because you think that is going to make Obama look successful. Obama is not even president anymore and he can no longer be president. He served two terms. Like, there's no need to go through that sort of political posturing, expand Medicaid, take the 100% and burst reimbursement that you're getting from the federal government and make sure that our state can continue to grow and expand. That's what we need to be doing and we're not doing it. But that's the way to address that question. That you talked about. >> Thanks for that and now for our third question. If you had to pick one thing that you wish the general public could better understand when it comes to immigration policy and maybe related to what you're already saying with the health care policies. If you could pick one thing that you wish, the general public could better understand when it comes to immigration policy. What would that be? >> I really wish that instead of focusing so much on the issues that we have at the border, I wish that people would understand and I think that some people do, but I don't think that, I don't think that the everyday texting in particular understands, is that I wish that people could realize just how interconnected we are. Our economies of the fact that, that we have had growth. I mean, we're very fortunate when you look at take a place like Detroit or some places in Ohio where they've seen population loss and they have communities that are getting older and older again, what that does the local economy is over a long term can really be a disaster. We've done well because of the immigrant community that we have both documented and undocumented to be quite frank with you. And I wish that people would just understand just how interconnected we are now with that said, we do need to come up with a system that allows people, two people to come to this country legally. So I'm not suggesting that otherwise, but we are interconnected. And I wish that there were more stories to explain that to people rather than, the emphasis that you see on the news, whether it's the conservatives called the liberal media or what people see on Fox News, the focus is on the border and focusing on that is really what divides us. And what I would like for people to understand is the value that this community has brought, again, particularly for Texans because they've helped us grow. They've helped us expand. We have more fortunate 1500 companies now here in the north Texas area that they have a New York city. And one of the reasons why is because people know that there's labor here, that there's good work being done here, there's affordable housing here. And if we were to have shortages in those areas, then we certainly would not continue to have the growth that we are. And people need to understand that we are interconnected and The fight should be us working together to improve our system to make unauthorized crossings less likely. >> So it sounds like what you're really driving at here is that immigration is necessary for a community to do well. Could you speak more to what it means to for communities in Texas to have done well, comparative, for example, you mentioned the communities and maybe Ohio where they're not doing so hot? Could you be more specific what done well means? >> Yeah, no, absolutely, I think a perfect example of that is look at Detroit, I'll talk about them and compare them to what's happening here now. In the 1950s, people moved to Detroit in large numbers, I mean you look at the great migration sadly one of the untold stories in American history where you had six million African Americans. Hopefully racism and poverty in the south to try and go and work in different places around the country, in the Midwest on the west coast. That would allow people to have a better, more full life without the worries of low wages and segregation. And Mr ford and General Motors needed the workers, and they were able to grow and sustain that community for decades. Because they had the workers, and they had the jobs, and it really worked together. They not had the workers and had they not have the population, then they certainly would not have been able to grow and make Detroit the large city that it ultimately became. And the same thing happening here in Texas right now. If you look at the growth that we're experiencing here in the north Texas area and housing in oil and gas, and hospitality, and retail, all of these were able to have that synergy. And create that level of dynamic here because of the workers that we have and because of the economy that we have, and so it really all goes together. And again, when you look at this last census report that just came out, that showed that we're in the lowest, because low births. And what they also said, it was the lowest immigration levels that we've seen Since the 1930s, those are the two things that they cite it. And right now, what we really have to start thinking about is how are we going to adjust to growth and recession if we can't figure out how to fix those things? And so it ought to be at the top of everyone's agenda to figure out how we're going to, basically in the United States, how we're going to go against the worldwide trend of birth weights. And at the same time, how we're going to increase legal immigration into this country. It's a huge issue is a huge problem and has to be solved or us and our kids, and definitely our grandkids, will really be in a hole for a long time to come if we don't. >> Excellent, so representative, we have just a couple more minutes, so I'd like to give you an opportunity to share anything that we haven't discussed. That you would like to speak on this topic of immigration and health care, there's any? >> Yeah, I would say on both issues that I know that people are growing frustrated and then people want to be able to move on to another topic or another cost that they find near and dear to their heart. But I just want to encourage everybody to continue to advocate in these areas, I think that there are vitally important for our country. We need reform, we need change, we need to fix are broken systems, and we can only do that if the public stays engaged. And so I understand people's frustrations, but just want to remind everybody that this is important. And when you think about the issue of civil rights in particular, that was something that affected my ancestors. I mean, that was something that the black community literally worked and fought hard on from the 18 seventies until 1970. It was literally 100 years of just slow gains, but we finally got there. And so I just want to urge people to not get frustrated and to keep your eyes on the prize and keep pushing. Because we need to keep having discussions around how we're going to improve health care, and how we're going to fix our broken immigration system. So we can make America a better place for everybody. >> Well, thank you so much for being with us here today, representatives. >> Thank you.