More States Provide Kidney Care for Undocumented Immigrants

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The number of states providing access to dialysis for undocumented immigrants has increased substantially over the past few years, according to a brief research report in Annals of Internal Medicine.

Using Medicaid and Emergency Medicaid (EM) manuals and other sources, the researchers analyzed the inclusion of undocumented immigrants for kidney failure, dialysis, and transplantation between March and October 2022. Data also included interviews with clinicians in each state who had provided kidney replacement therapy to at least two undocumented immigrants over the past 5 years.

The study found that 20 states and the District of Columbia provided statewide coverage for standard outpatient hemodialysis for undocumented immigrants. Hemodialysis was provided through EM in 17 states and through Medicaid or state insurance pools in the rest. Five states—California, Illinois, Massachusetts, Minnesota, and New Mexico—provided coverage for kidney transplantation.

A 2019 study reported that 12 states and the District of Columbia offered coverage for dialysis by including kidney failure as a qualifying condition under EM. In 2022, the number of states providing statewide coverage for hemodialysis in undocumented immigrants increased to 20. “The expansion of dialysis coverage may be due to increasing awareness of poor outcomes with emergency hemodialysis and heightened advocacy efforts,” the researchers write [Rizzolo K, et al. Access to kidney care for undocumented immigrants across the United States. Ann Intern Med, published online ahead of print April 25, 2023. doi: 10.7326/M23-0202;].