Coverage of Transplants for Undocumented Immigrants Stirs Debate

There is a growing debate over organ donations for undocumented immigrants in California, with state coverage of such services occupying a central role in discussions, the Los Angeles Times reports.

Undocumented immigrant children in California with severe, chronic illnesses are eligible for no-cost health services from the state until they turn 21, when many lose health coverage and encounter difficulties receiving necessary care, according to the Times.

The immigrants are supposed to be seamlessly transferred to receive low-cost or no-cost care through county medical services or indigent care programs, but those programs often do not cover organ transplants.

However, Norman Williams, spokesperson for the Department of Health Care Services, said if undocumented immigrants inform the state in writing that U.S. immigration services "is aware of their presence and does not plan to deport them," they could be eligible for the full-scope of Medi-Cal.

In such cases, Medi-Cal covers the cost of organ transplants, raising further questions about including undocumented immigrants on waiting lists for organ transplants.

Immigration status is not considered in allocating organs, but some say that undocumented immigrants should not receive costly organ transplants ahead of documented residents and U.S. citizens, the Times reports.

Michael Shapiro, vice chair of the ethics committee for the United Network for Organ Sharing, said illegal immigrants have just as much a right as U.S. citizens to the organs, adding that more undocumented immigrants likely donate organs than receive them.

More than 90% of last year's 767 liver transplants in California were provided to U.S. citizens.

Sue McDiarmid, medical director of UCLA's pediatric liver transplant program, said the larger problem is that the state health care system terminates coverage for undocumented immigrants who are covered as children.

Stan Rosenstein, chief deputy director of health care programs at DHCS, said "We are strong believers in continuity of care so it is concerning when you have a break in coverage" (Gorman, Los Angeles Times, 4/13).