One Friday morning this summer, Rosario Ortegón, 55, woke up feeling an immense sense of sadness. As much as she tried, she couldn’t stop worrying about “everything that was going on.”
Leaving her house for the day, she altered her route to avoid the Mission District after hearing a rumor, later proven to be false, that Immigrations and Customs Enforcement was in the neighborhood. On the bus, she mulled over a news clip from Despierta America reporting that the Trump Administration had issued new directives restricting immigrant access to healthcare.
By the time she made it to her acupuncturist’s office, she said, she was sobbing.
She lay on the massage table, and felt her acupuncturist put needles across her face and body. Soon after, Rosario fell asleep. By the time the session ended and her needles were removed, she was feeling lighter.
For two years, Ortegon has relied on acupuncture to treat recurring migraines, which she says have eased considerably. Over time, she’s also turned to the Traditional Chinese Medicine (TCM) approach to navigate her mental health during biweekly sessions. Around the Bay Area, treatments typically cost hundreds of dollars per session, but Rosario accesses them for free through Medi-Cal.
“It doesn’t compare to anything else,” she said. “I would rather have needles than pills”
Medi-Cal has covered acupuncture treatments for Californians with chronic pain like Rosario since 2017. Once considered a fringe practice, the 3,000-year-old treatment has been increasingly embraced and recommended by U.S. healthcare professionals.
In San Francisco, city-run and nonprofit healthcare providers that cater to low-income residents have offered acupuncture for decades as part of an integrative approach to healing, combining conventional medicine with holistic care to treat a number of conditions, from depression to chronic pain. The treatment has few side effects beyond localized pain and slight bleeding, allowing physicians to provide relief to their patients without invasive procedures or addiction risks.
“We’ve had some substance abuse issues in the last several years,” said Johanna Liu, president of the San Francisco Community Clinic Consortium. “So we see [acupuncture] as a key, important alternative to offer people during those times.”
Beyond serving as an alternative to opioids, many providers see acupuncture as a way to bridge cultural barriers and meet the healthcare needs of San Francisco’s diverse, working-class and immigrant communities, a resource that, as budget cuts loom, might be at risk of disappearing.
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A popular solution
Reyna Colores, 61, said she first tried acupuncture in 2015 after she injured her collarbone in a car accident. Curious to see if it would work, she visited a private clinic recommended by a friend that allowed her to pay on a sliding scale. Though the needles felt uncomfortable, she kept going until she was able to move her arm again.
A few months ago, when an ear infection left Colores with facial paralysis, she grew frustrated with the lack of answers from her doctor and turned to acupuncture again, this time at a nonprofit clinic. She has since recovered most of her facial mobility. Now, she’s searching for an affordable provider to help her address her mental health.
Colores is not the only one. Her friend, Bertha Embriz, 60, maps her weeks around affordable acupuncture. The Rafiki Collective on Mondays, the Women’s Resource Center on Tuesdays and the San Francisco General Hospital’s drop-in hours on Wednesdays — though she notes you need to be enrolled in one of the city’s primary health clinics. Diagnosed with arthritis in 2015, she relies on acupuncture and physical therapy to treat knee pain while avoiding medications.
“I have a lot of faith in acupuncture, in everything that’s natural medicine,” Embriz said. “It’s helped me a lot.”
Health care providers are taking note of this growing interest among Latinos. In January, the Mission Neighborhood Health Center (MNHC) opened its first acupuncture clinic at its Shotwell Street location in the Mission District, offering free and sliding-scale services.
It took a bit for people to warm up to the needles. At first, staff had to recruit someone to be their first patient. But demand quickly surged. People who found acupuncture through their physicians recommended acupuncture to their family members. Friends would urge each other to book an appointment.
“I knew it would be popular but not this popular,” said Willie Ramírez, MNHC’s chief strategy officer. If demand continues to rise, he added, the clinic is considering hiring another acupuncturist.
Appointments are now booked almost two months in advance. Igor Alekseev, MNHC’s acupuncturist, sees about 200 people a month. About 90% of them, he added, are Spanish speakers.
Many patients are middle-aged Latinos working low-paying, labor intensive jobs: restaurant workers, babysitters or construction workers. Acupuncture, Alekseev said, helps them manage workplace injuries and chronic pain from years of hard labor.
Cultural connections between continents
Beyond the needles, acupuncture is a “whole healing ritual” said Dr. Kevin Liou, an integrative medicine specialist at the Memorial Sloan Kettering Cancer Center in New York City. In fact, in TCM, acupuncture is believed to rebalance the body’s energy flow, or chi, by placing needles on specific pressure points.
Increasingly researchers like Liou are finding that Latino patients are resonating with acupuncture because of their familiarity with other natural and ritual-based remedies like curanderismo, as well as their skepticism towards pharmaceuticals.
“They don’t just want medication that’s going to mask the pain, they want to figure out what is the root cause of the pain and how to fix that so that they don’t continue to struggle with the symptom itself,” said Eloisa González, director of integrative medicine at the Wellness Center at Los Angeles General Medical Center. “I think [acupuncture] aligns with this sort of cultural way of thinking about health and how to approach getting better.”
Lili Qiao, who directs the department of integrative medicine at North East Medical Services (NEMS), said acupuncture’s popularity comes down to the fact that it “works well” and is “low risk.”
“When you are already dealing with the language barriers or limited access to care, to be able to receive some treatments that align with your culture and values really makes a difference,” Qiao said.
Founded in Chinatown, NEMS is a major provider for San Francisco’s Chinese community, where acupuncture has strong cultural roots. Yet many of the symptoms its acupuncturists treat, and the preference for non-pharmacological treatments, transcend cultures.
“We’re sharing values around holistic healing, right? Latino cultures have different healing methods, but it’s the same thing,” Qiao said. “Because we are not only treating the symptoms, we’re restoring the whole person.”
How effective is acupuncture?
Not everyone finds success in acupuncture, and research continues to debate how much of its effectiveness comes from the placebo effect as opposed to the way needles stimulate certain nerves and trigger bodily responses. Still, providers have continued leaning into the practice, especially as insurance providers have expanded access.
The San Francisco Department of Public Health, which offers acupuncture at 11 of its neighborhood clinics that cater to low-income residents, said acupuncture has been “well-received” by people of “all backgrounds and ethnicities.”
In a statement to El Tecolote, DPH noted that acupuncture is effective for acute and chronic pain, migraines and arthritis, and remains popular among the San Francisco Health Network’s (SFHN) patients as a source of relief.
Bracing for cuts
Despite its popularity, acupuncture’s future for low-income Californians is uncertain.
This is the second year that Gov. Gavin Newsom has proposed cutting it from Medi-Cal’s budget. Each time, a coalition of healthcare providers, local politicians, and patients has successfully fought to preserve it.
“We were all [sharing the] same message that acupuncture is a critical benefit,” said NEMS governmental affairs representative Kenneth Wilkerson. “It provides services and benefits to patients that are really, really critical and it helps lower emergency room visits.”
But after President Donald Trump signed the One Big Beautiful Bill Act (OBBBA) this summer, which includes sweeping Medicaid cuts, California faces even tougher budget decisions. Providers fear acupuncture could once again be on the chopping block.
“We have our ear to the wind, working with different legislators in the state, in the assembly, just trying to get a grasp of what exactly will happen,” Wilkerson said. “But again, we don’t have a crystal ball.”
A way for immigrants to find solace
For immigrant patients, fear of enforcement adds another barrier. Colores, for instance, now depends on her children to drive her to her appointments, worried about encountering ICE agents.
Acupuncturist Shannon Piercy-Alvarez, who offers sessions in English and Spanish, says many of her Latino patients are skipping appointments altogether, while others arrive visibly anxious.
“For some people, this is the appointment that they come to. Sometimes they don’t want to leave their house,” said Piercy Alvarez, who has a private practice in the Castro and accepts Medi-Cal. “I’m getting a lot of fear and a lot of stress and anxiety from it as well, just like that hypervigilance of ‘They’re going to come after me.’”
During sessions, Piercy-Alvarez helps patients release tension in their upper body and clenched jaws. Needle by needle, she says she relaxes their muscles so that they’re able to sleep better, making it easier “to navigate their lives through the world.” Many times, she says, the healing also comes through conversation.
“A lot of times, people come in and they talk for a while,” she said. “Especially when women come in and then I spend maybe half the session listening to what’s going on in their lives, you know, frustration, relationships, everything…. Whether it’s a shortage of bilingual therapists, I don’t know, but a lot of times people are just like: ‘You understand me.’”
This project was supported by the USC Annenberg Center for Health Journalism, and is part of “Healing California”, a yearlong reporting Ethnic Media Collaborative venture with print, online and broadcast outlets across California.