Health Services For Undocumented Immigrants Vary State By State In Absence Of Federal Guidance

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health
Article Date: 30 Oct 2008 - 5:00 PDT

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With "limited federal guidance" on what health care services undocumented immigrants are eligible to receive, many states are "grappling" with what services to provide, the Los Angeles Times reports. Federal law prohibits the use of federal funds to pay for nonemergency care to undocumented immigrants, but it is not clear what counts as an emergency, the Times reports. The federal government defines an emergency as "an acute condition that, without immediate care, would seriously jeopardize a patient's health or impair bodily functions, parts or organs," according to the Times. The federal government shares the cost of emergency care for undocumented immigrants with states through Medicaid. Congressional and legal efforts to further define services undocumented immigrants can receive have not been successful or clarified the issue, the Times reports.

Health and other benefits for undocumented immigrants vary state by state, the Times reports. Some states "tip toward the need to care for the sick," while others "see free health care as a de facto endorsement of [undocumented immigrants'] presence," according to the Times. In particular, there are discrepancies over whether services such as chemotherapy, life-support and dialysis are considered emergency care.

Some states -- including Colorado, New Mexico and Texas -- do not consider kidney failure an emergency condition because patients can survive for weeks without dialysis before the disease becomes fatal. Other states -- such as California, New York and North Carolina -- provide routine dialysis for undocumented immigrants. Georgia recently stopped paying for dialysis for undocumented immigrants after lawmakers said it was a financial burden on the state.

In early 2007, Mary Kahn, a spokesperson for the federal Medicaid program, said, "We do not pay for chronic care for illegal immigrants." However, she recently said that the federal government and California have been sharing the cost of providing dialysis for undocumented immigrants and that it has been up to states to decide whether to pay for various health services themselves.

The cost of one dialysis treatment is about $250, according to the Times. Undocumented immigrants who do not receive routine dialysis often end up in emergency departments when they are sometimes near death, and where care often costs much more, according to the Times. When patients are near death, federal law says they must receive dialysis until their condition stabilizes. Without routine care, however, their condition often deteriorates and they have to return to the ED weeks later. States that do pay for dialysis say that not covering routine dialysis is far more costly than the alternative.

In California, undocumented immigrants account for 1,350 of 61,000 people receiving state-funded dialysis, and the group's portion cost the state $51 million last year. Opponents of the policies are against using taxpayer funds to pay for services to undocumented immigrants, and some states are concerned that covering the life saving procedures would draw more undocumented immigrants to their jurisdictions (Zarembo/Gorman, Los Angeles Times, 10/29).

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