Should illegal immigrants get transplants at taxpayer expense?

Los Angeles Times

LOS ANGELES — Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the U.S. to seek medical care. She underwent two liver transplants at the University of California, Los Angeles Medical Center as a child in 1989 and a third in 1998, each paid for by the state.

But when Puente turned 21 last June, she aged out of her state-funded health insurance and the ability to continue treatment at UCLA.

This year, her liver began failing again and she was hospitalized at County-USC Medical Center, affiliated with the University of Southern California. In her Medi-Cal application, a USC doctor wrote, “Her current clinical course is irreversible, progressive and will lead to death without another liver transplant.” The application was denied.

The county gave her medication but does not have the resources to perform transplants.

Late last month Puente learned of another, little-known option for patients with certain health-care needs. If she notified U.S. Citizenship and Immigration Services that she was in the country illegally, state health officials might grant her full coverage through Medi-Cal, the state health services assistance program for the poor. Puente did so, her benefits were restored, and she is awaiting a fourth transplant at UCLA.

Puente’s case highlights two controversial issues: Should illegal immigrants receive liver transplants in the U.S., and should taxpayers pick up the cost?

The average cost of a liver transplant and first-year follow-up is nearly $490,000, and anti-rejection medications can run more than $30,000 annually, according to the United Network for Organ Sharing, which oversees transplantation nationwide.

Donor livers are in scarce supply. In California, nearly 3,700 people are on a waiting list for livers, according to the network. Last year, 767 liver transplants were performed in the state. More than 90 percent were given to U.S. citizens.

Donor livers generally are allocated through a geographic-based distribution system on the basis of how sick the patients are and how long they have been on the transplant waiting list. Immigration status does not play a role in allocating organs.

But some people say that it should and that illegal immigrants should return to their home countries for care rather than receive organs and costly transplants ahead of legal residents and U.S. citizens.