Kidney Transplants More Cost Effective Than Longterm Dialysis For Undocumented Across the country, there are about 6,500 undocumented immigrants with kidney failure, according to the National Institutes of Health. What kind of care they get depends on where they live.
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Transplants A Cheaper, Better Option For Undocumented Immigrants With Kidney Failure

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Transplants A Cheaper, Better Option For Undocumented Immigrants With Kidney Failure

Transplants A Cheaper, Better Option For Undocumented Immigrants With Kidney Failure

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MICHEL MARTIN, HOST:

Uninsured, undocumented immigrants often go to the emergency room for treatment. That's because since 1986, the federal government has required that patients in the emergency room receive care regardless of their immigration status or ability to pay. But caring for chronic conditions like kidney disease or cancer in the emergency room is expensive, so some states are quietly expanding access for undocumented immigrants to obtain medical treatment beyond the ER. From member station KUOW in Seattle, Eilis O'Neill reports.

EILIS O'NEILL, BYLINE: Gonzalo is really sick.

GONZALO: (Speaking Spanish).

O'NEILL: Gonzalo says he can't enjoy the day, go out because he's always unwell. Gonzalo moved to the U.S. from Mexico about 30 years ago. He's 60 years old. We're not using his last name because he's undocumented. Ten years ago, Gonzalo's kidneys failed. Since then, he's gotten sicker and sicker. Five years ago, he had to quit his job as a painter.

GONZALO: (Speaking Spanish).

O'NEILL: Gonzalo says he used to pay the rent. He paid for everything, and his family didn't lack anything. But he got sick, and everything changed.

GONZALO: (Speaking Spanish).

O'NEILL: Now Gonzalo lives with one of his daughters in her apartment south of Seattle. Across the country, there are more than 6,000 undocumented immigrants with kidney failure, according to the National Institutes of Health. What kind of care they get depends on where they live.

In most states, they can only get dialysis in the ER. That means every couple of weeks, they go to the hospital when so many toxins have built up in their body it's life-threatening. Usually, they have to stay overnight so they can be dialyzed twice. That costs nearly $300,000 per person every year. So seven states, including Washington, have a different system.

LEAH HASELEY: The state of Washington has something called AEM.

O'NEILL: Leah Haseley's a nephrologist - a kidney doctor - in Seattle. She's talking about Alien Emergency Medical programs. It's part of Washington's Medicaid.

HASELEY: And AEM pays for two things. They pay for dialysis for undocumented people, and they pay for chemotherapy, for cancer treatment, for undocumented people as well.

O'NEILL: Regular dialysis costs about a quarter of what emergency dialysis does. But it's controversial. Matthew O'Brien is with the Federation for American Immigration Reform.

MATTHEW O'BRIEN: I think the first time that you show up at a hospital with kidney failure, that's an emergency. After that, it's a chronic condition, and we don't believe that it's appropriate to reward lawbreakers with benefits at the expense of U.S. taxpayers.

O'NEILL: But there are others who say even regularly scheduled dialysis isn't enough. Undocumented immigrants who qualify should be given kidney transplants, but without health insurance, few can afford the cost. In 2015, Illinois became the first state with a system for paying for organ transplants for undocumented immigrants. Dr. David Ansell was a prominent advocate for the change.

DAVID ANSELL: In about a year and a half, the cost for a transplant pays itself back. But also, people can go back to work and contribute to the state.

O'NEILL: So far, more than 200 undocumented immigrants have been given access to organ transplants with their insurance premiums paid for by a nonprofit. Now Dr. Ansell and other public health advocates hope to see a similar program at the national level. Many who oppose this say with limited organs available, they should be reserved for citizens and legal immigrants. But Dr. Ansell says, in Illinois, 75% of kidney transplants for undocumented immigrants come from donations from their own family - a much higher rate than the rest of the population.

ANSELL: If you're undocumented in Illinois, you can get a driver's license. And disproportionately, the Latino community is signing up to donate their organs.

O'NEILL: Dr. Ansell says it's a simple matter of ethics and fairness. And since Illinois started paying for the transplants, the total number of organs available has increased because so many more Latinos have signed up for organ donation. Overall in the U.S., studies have found that undocumented immigrants donate 2% to 3% of all organs. Back in the Seattle area, Gonzalo says all three of his daughters are willing to give him a kidney, but he has no way to pay for the transplant. That's why his wife, Ricarda, says she's taken to buying lottery tickets.

RICARDA: (Speaking Spanish).

O'NEILL: Ricarda says she's told her husband, "if I win the lottery, I won't think twice. I'm going to get you a kidney."

For NPR News, I'm Eilis O'Neill in Seattle.

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