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general revenue funds and some federal programs. Special facilities and community and ruralhealth centers/clinics are largely funded through federal money (Title V, Title X, Ryan White,block grants, Medicare and Medicaid) along with the state matching dollars. Local healthdepartments rely on federal, state, and local funding sources for their programs. Free clinics onthe other hand rely on fundraising and volunteers, while private physicians’ contributions to theindigent are from their own earnings. 17Immigrant Health CareAccording to the U.S. Census Bureau, 24.6 percent of Texas residents are uninsured. 18 In2003, over half of the uninsured in Texas were Hispanic, many of whom were immigrants fromMexico. In 2002, there was an estimated 1.4 million immigrants of Hispanic origin living inTexas. 19 It is very difficult to know how many of the immigrants living in Texas areundocumented, however some have estimated the number at over 1 million. 20These figures are notable because Hispanics, and particularly Mexican immigrants, areoverrepresented in jobs with limited or no health insurance. This is important because Medicaidin Texas does not cover recent documented immigrants or undocumented immigrants.The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA),made legal immigrants who entered the United States after 1996 ineligible for Medicaid for fiveyears. PRWORA gave states the option to continue Medicaid coverage for qualified immigrantadults who entered the U.S. before the law was enacted in August 1996, which Texas did.Qualified immigrant adults entering the U.S. after August 1996 were barred from Medicaidcoverage for five years from date of entry (although at that time emergency Medicaid was stillavailable). 21 In the 2003 legislative session, the state’s emergency Medicaid program wasdiscontinued. States do have the option to cover post-1996 qualified adult immigrants after thefive-year bar, but Texas is not yet exercising this option. Senate Bill 1156 of the 77th TexasLegislature, which Governor Rick Perry vetoed, would have, among other things, exercisedTexas’ option to cover post-1996 qualified immigrant adults following the five-year bar period.Because most undocumented immigrants are low-wage earners and have very limited access toformal health care coverage (public or private), they depend largely on local or county-fundedprograms, community health centers (FQHCs or FQHC look-alikes), and charitableorganizations. County-funded programs, which are responsible for providing health care foruninsured indigent individuals, provide services regardless of immigration status. Communityhealth centers also play a crucial role in providing health care services to Texas’ poor Hispanicand immigrant populations. Patients are only required to live within the service area, and arenot asked to provide documentation regarding immigration status. In 2003, there were 35 CHCsoperating 195 service delivery sites across the state, serving a total of 547,816 people, 71percent of whom were Hispanic. Of these people, 94 percent earned less than 200 percent FPLand 76 percent earned less than 100 percent FPL. 22 Charitable organizations also provideservices similar to those of FQHCs, however they receive little or no public funding. Examplesare El Buen Samaritano and People’s Community Clinic in Austin.Health care coverage for immigrant children is also somewhat limited. States have the option touse state funds to cover immigrant children on Medicaid during the five-year bar period butTexas covers these children with SCHIP funds. 23 All qualified immigrant children may receivestate-funded care following the five-year bar. No bar is placed on qualified immigrant childrenarriving before 1996. Undocumented children face greater difficulty accessing acute care,preventive, and primary care services. These children often rely on FQHCs for their health careB-51