Los Angeles Times Examines Medical Coverage for Chronically Ill Undocumented Immigrants
The Los Angeles Times on Sunday examined a "little known option" for undocumented immigrants in California with certain medical needs: if they notify U.S. Citizenship and Immigration Services that they are not U.S. citizens, they could be eligible for health care benefits through the state's Medicaid program, Medi-Cal. The Times profiled the case of 21-year-old Ana Puente, an undocumented immigrant with a liver disorder who has received three liver transplants and other care at UCLA Medical Center since she was an infant.
Undocumented immigrant children with certain severe, chronic illnesses are eligible to receive care under the California Children's Services program until age 21. After age 21, undocumented immigrants can receive no-cost or discounted health care through county programs that serve the indigent or, in some cases, through emergency Medi-Cal. However, in Los Angeles County, neither program covers liver transplants, and "when they become adults, patients like Puente often have to switch doctors and hospitals and may lose access to necessary medical care," the Times reports. Norman Williams, spokesperson for the state health department, said that if undocumented immigrants inform the state in writing of their presence and if federal officials have no plans to deport them, they could be eligible for full Medi-Cal coverage, which includes liver transplants. Medical condition is taken into account in determining whether immigrants receive Medi-Cal coverage, the Times reports.
Ethical Issues
Puente's case "highlights two controversial issues: Should illegal immigrants receive liver transplants in the U.S. and should taxpayers pick up the cost," according to the Times. The average cost of a liver transplant and first year of follow-up care is almost $490,000, according to the United Network for Organ Sharing. Anti-rejection medications can cost $30,000 annually. Immigration status is not taken into account when allocating donated organs. In 2007, more than 90% of liver transplants in California went to U.S. citizens.
Roy Beck, executive director of NumbersUSA, which favors stricter controls on immigration, said, "All transplants are about rationing," adding, "I just don't think the public ought to be funding any kind of benefits for people who are breaking the law." However, Michael Shapiro, vice chair of the ethics committee for the organ network, said that undocumented immigrants have the right to organ transplants and that they likely donate organs more than they receive them. "People are people, and when you make an incision in an organ donor, you don't find little American flags planted on their organs," Shapiro said. Andrew Stolz, director of the liver consultation service at Los Angeles County Hospital + USC Medical Center, said there are about 10 liver transplant patients at the hospital receiving care who aged out of the California Children's Services program and are now uninsured, but he is unaware how many of those patients are undocumented immigrants (Gorman, Los Angeles Times, 4/13).