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Study Looks at Access to Kidney Care for Undocumented Immigrants

20 states and Washington, D.C., provide coverage for outpatient hemodialysis; five states also provide cover for kidney transplant

By Elana Gotkine HealthDay Reporter

MONDAY, April 24, 2023 (HealthDay News) — Twenty states and the District of Columbia (DC) provide coverage for outpatient hemodialysis for undocumented immigrants, five of which also provide coverage for kidney transplantation, according to a research letter published online April 25 in Annals of Internal Medicine.

Noting that in many states, undocumented immigrants with kidney failure rely on emergency dialysis, which requires hospitals to provide emergency care regardless of ability to pay, Katherine Rizzolo, M.D., from the University of Colorado in Aurora, and colleagues conducted a cross-sectional study to catalog access to health insurance for kidney replacement therapy for undocumented immigrants across all 50 U.S. states and D.C.

The researchers found that 20 states and D.C. provide statewide coverage for standard outpatient hemodialysis for undocumented immigrants, 17 of which provide outpatient hemodialysis through emergency Medicaid. In California and Massachusetts, full Medicaid is provided to undocumented people, while in Illinois, full Medicaid is provided to those meeting certain age and income criteria. A high-risk insurance pool is used in New Mexico, and a municipal-funded program is available in D.C. Five states (California, Massachusetts, Minnesota, Illinois, and New Mexico) cover kidney transplantation for undocumented immigrants. Systems in place vary and include Medicaid coverage with supplementary private insurance via a charity group in Illinois and inclusion of organ transplantation under the definition of kidney failure covered under emergency Medicaid in Minnesota.

“The heterogeneity of these systems allows for a wide range of strategies that can guide efforts in other states,” the authors write.

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