One of the most important goals for undocumented immigrants and their advocates is to give everyone, especially children, access to affordable health care services.

Depending on political orientation, each state, county and city has its own policies on health coverage, causing the health access map to be uneven.

There is evidence that many undocumented immigrants live with unmet health care needs. Hispanics, in general, have less access to health services than whites, Asians and African-Americans.

Even though some undocumented immigrants may, technically speaking, have private health insurance, low incomes deter most of them from access. In other words, while some undocumented immigrants can obtain private insurance (whether through an employer or on the open market), most are uninsured.

It’s expensive, and it’s wrong, and it’s unhealthy only treating uninsured people when they show up at the emergency room

Undocumented immigrants are much less likely than U.S. citizens or legal immigrants to have private health insurance, and since they cannot pay for regular care, their access is limited to emergencies, sometimes in life and death situations.

In spite of this somber scenario, some states, counties, and cities are making some progress. Here are some notable ones:

California

California has become one of the few states to offer all children, regardless of their immigration status, access to health services through free or low-access fees. In 2015, California state legislation passed an expansion to Medi-Cal, which is starting to be implemented. It is estimated that up to 250,000 children can enroll now in this program since May 16, 2016.

New York City

Immigrants in New York City have more health insurance options than in many other states. Children and pregnant women from low-income families are covered, and DACA recipients are applying for health insurance. Authorities in the city assure immigrants that applying for these benefits won’t affect the individual’s immigration status or application for status.

Cook County

Cook County in Illinois, the second most populous county in the nation, launched an initiative this past September to provide health services to individuals lacking health insurance who do not qualify for Medicare. Many of Illinois’ uninsured are young adults, immigrants living here illegally, and lawful immigrants who don’t yet qualify for Medicaid, said Kathy Waligora, director of the health reform initiative of EverThrive Illinois, an advocacy organization.

In the long run, this strategy is designed to save money by offering individuals regular health care, which studies show reduces the use of costly emergency rooms.

“It’s expensive, and it’s wrong, and it’s unhealthy only treating uninsured people when they show up at the emergency room,” said Dr. Jay Shannon, CEO of the Cook County health system.