Miguel hadn't seen a doctor in eleven years. Now he sees one every six months.

Miguel has worked the strawberry fields outside Salinas since he was nineteen. For most of those years, his health was something he tried not to think about — partly because there was never enough money, and partly because nobody had ever sat down with him and explained how any of it worked.

Last spring, an outreach worker from a partner clinic met him after a long shift. They talked in Spanish about his sore back, his diabetic uncle, his daughter starting community college. By the end of an hour, Miguel had enrolled in a low-cost ACA plan with low-copay telehealth visits and a five-dollar prescription tier.

Six months later, Miguel had his first full physical since 2013. The clinic caught early-stage high blood pressure and put him on a generic medication. 'It's the kind of thing,' he says, 'that I would have ignored for ten more years.'