Maria Portela Martinez, MD, MPH

2013-2014

Assistant Professor, Chief of Family Medicine; Bridge to Care Medical Director, The George Washington University School of Medicine and Health Sciences, Washington, DC

Dr. Portela is the chief of the Family Medicine Section within the Department of Emergency Medicine at the Medical Faculty Associates at George Washington University (GW). She is also the medical director of the George Washington Immediate Primary Care Clinics. Through these roles, she works towards expanding GW’s footprint of primary care and family medicine. At the Medical Faculty Associates, she seeks to improve access and quality of care in the community as well as increase family medicine exposure and mentorship opportunities for students. Dr. Portela is an assistant professor at the GW School of Medicine and Health Sciences, where she serves as a Professional Development Mentor and a Public Health Mentor for medical students. Dr. Portela is also co- Principal Investigator of the Healthworkforce Diversity Initiative and Diversity Tracker.

Prior to GW, Dr. Portela worked in HHS at the Health Resources Services Administration leading efforts to re- envision primary care training focused on transforming health care delivery systems aimed at improving access, quality of care, and cost-effectiveness. Dr. Portela previously provided volunteer clinical services at Unity Health Care, a Federally Qualified Health Center in Washington, D.C. and in 2017 was an Atlantic Fellow for Health Equity at GW.

Previously, while pursuing medical school training in her native Puerto Rico, she shared in the development of an assessment on the health and education sectors for President Obama's Task Force on Puerto Rico's Economic Development. Subsequently, she pursued residency training at Duke, and completed the Commonwealth Fund Fellowship in Minority Health Policy at Harvard, where she obtained her master's degree with concentrations in Public Health Leadership and Health Policy and Management.

Dr. Portela has taken diverse leadership roles and has served in local, state and national health equity boards and committees. She is passionate about increasing access and quality of health care services to vulnerable populations, and about teaching, mentorship, diversity, and inclusion.

May 5, 2014 | Harvard T.H. Chan School of Public Health Video Series
Why Public Health? Maria Portela Martinez

Undocumented Immigrants, waiting for Health and Immigration Reform

Objectives:     

To explore the intersection between Immigration and Health Reform. To examine ways of protecting and increasing health care services and access that undocumented immigrants receive in order to preserve safety net hospitals viability and provide quality care to all.

Background:     

We are at a particular moment in history that can be transcendental for immigration legislation. In addition, in 2010 we just recently passed the Affordable Care Act (ACA) the most significant piece of Health Care Legislation for Americans since 1965. Previous to the ACA an estimated 50million people were uninsured in the United States1, of these an estimated 15% are undocumented immigrants2. The ACA translates into some positive gains for legal immigrants10. However, undocumented immigrants are excluded from the ACA provisions and might fare worse off10. There are over 11 million undocumented immigrants in the US2. The ACA includes some significant cuts to public subsidies such as Disproportionate Share Hospital that has traditionally helped fund safety net hospitals where many undocumented immigrants receive health care services3,10. In states that are not expanding Medicaid, these cuts threatens the viability of safety net hospitals3,4,8 whereas much as 77% of the total discharges belong to Medicaid and uninsured patients versus <30% of discharges in Academic Centers5,4,6. In addition to the care they provide to the poor, >25% of safety net hospital own over 85% of the market share for some sub-specialty services that the whole community utlizes7.

Methods:    

Conducted a literature review regarding undocumented immigrant health care access. Conducted expert interviews and a review of immigration and health reform policies for the past 30 years

Results:     

We are at an interesting point in history where an Immigration Reform bill  S.744-Border Security, Economic Opportunity, and Immigration Modernization Act10 is on in the House of Representatives and a health care bill introduced in March, 2014 H.R.4240 “Health Equity And Access Under The Law For Immigrant Women And Families Act Of 2014″11 (HEAL) proposes including DACA eligible individuals to be included in the exchanges, to have Medicaid eligibility, and bans the five-year waiting for lawfully present individuals from receiving federal subsides11 are both in Congress. Commonalities of previous national insurance expansions have all been incremental. Products of this project include a policy brief, a position statement, and an informational advocacy guide

Future Directions:     

Some opportunities for gains can be achieved by advocating and creating a coalition that supports H.R.4240 initiatives. By focusing on incremental insurance expansions and compromising by choosing a subset of the population such as children, DACA eligible individuals or other vulnerable populations we can have achieve legislative change.

Preceptors:    

Bruce Siegel, MD,MPH, Chief Executive Officer, America’s Essential Hospitals and Shawn Gremminger, Vice President of Advocacy, America’s Essential Hospitals